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5?4 


ANNALS 


ATO  \'(r'*d» 


TRANSACTIONS 


or  THE 


BRITISH    HOMCEOPAI 
SOCIETY, 


AND   OF   THE 


VOL  IV. 

(POBLISBBO   BT   ACTHORITT   OF  THE   SOCIBTT.) 


LONDON : 

LEATH  AND  CO.,  5.  ST.  PAUL'S  CHUECH 
And  9,  VERB  STREET,  OXFORD  STREI 

1864. 


PREFATORY    NOTICE. 


The  completion  of  the  Third  Volume  of  "  The  Amials/' 
demands  but  few  prefatory  remarks. 

The  Editing  Committee  have  the  satisfaction  of  con- 
gratulating the  Society  on  the  steady  success  of  the 
publication,  as  evinced  in  the  growing  favour  with  which 
its  numbers  are  welcomed,  both  at  home  and  abroad — 
favour  which  proves  the  soundness  of  the  principles 
on  which  the  work  was  commenced,  and  to  which  the 
Editing  Committee  have  strictly  adhered. 

The  present  volume,  it  is  believed,  will,  in  every  res- 
pect, bear  favourable  comparison  with  its  predecessors. 
This  is  due  to  the  laudable  zeal  which  has  prompted  the 
production  of  so  many  valuable  essays ;  to  the  useful  in- 
formation, and  free  expression  of  opinion,  contained  in  the 
discussions ;  and  to  the  more  extended  form  in  which  the 
latter  are  reported.  The  Society  is  indebted  to  one  of 
its  Corresponding  Members  for  an  interesting  com- 
munication, on  a  new  medicine,  which  appears  in  the 
latter  pages  of  this  volume. 


vi  Prefatory  Notice, 

Limited  space  has  rendered  it  impossible  for  the- 
Editing  Committee  to  publish  all  the  materials  at  their 
disposal.  In  making  their  selection,  they  have  been 
guided,  chiefly,  by  the  practical  character  of  the  papers, 
and  by  the  amoimt  of  interest  they  excited,  when  read 
before  the  Societ3\ 

In  conclusion,  the  Editing  Committee  Avish  to  express 
their  gratification,  at  the  increasing  usefulness  and  pros- 
perit}'  of  the  London  Homceopathic  Hospital,  whiclv 
whilst  it  dispenses  the  blessings  of  Homoeopathy  to  large 
munbers  of  the  poor,  continues  also  to  afford  to  Medical 
Inquu'ers,  an  opportunity  of  witnessing  the  practical 
application  of  the  principles  propoimded  by  Hahnemann^ 

Frederic  Foster  Quix. 
John  Rutherfurd  Russell^ 
Stephen  Yeldham. 
Hugh  CA^rEROx. 


CONTENTS. 


Prefidorj  Notice  to  the  Third  Volame  of  the  Annals. 

No.  xni. 

80C1ETT. 

FAOE. 

1.  Is  the  Doctrine  of  lufinitessimals  Consistent  with  Reason  and  Experience  ? 

By  Dr.  Samnel  Cockbnm  ......  I 

2.  Discussion  (in  which  Dr.  Hale,  Dr.  Metcalfe,  Dr.  Eiddj  Dr.  Drnry,  Dr. 

Wyld,  Dr.  Rnssell,  and  Dr.  Chapman  took  part)    .  .  •  .29 

3.  Addressof  the  President,  Dr.  Qmn,  at  the  Annnal  Assembly  of  1863  .        4» 

4.  Unpablished  Letters  of  Hahnemann  •  .  •  .  .61 

HOSPITAL. 

5.  Concluding  Lecture  on  Rhenmatism — On  the  Dose  and  the  Alternation  of 

Medicines.    By  Dr.  Russell  ......        72 

6.  Case  of  Ovariotomy  ...••..        91 

No.  xiy. 


1.  The  Positive  Services  of  the  School  of  Hahnemann,  Exemplified  in  the 

Treatment  of  Acute  Inflammatory  Disease.    By  John  Ozanne,  M.D.       .        97 

2.  Discussion  (in  which  Mr.  Ycldham,Dr.  Hughes^  Dr.  Russell,  Dr.  Chapman. 

Dr.  Chepmell,  and  Dr.  Qnin  took  part)     .  .  .  .  .113 

3.  On  Some  Afifections  of  the  Knee-Joint.     By  Dr.  Ransford  .  .128 

4.  Discussion  (in  which  Dr.  Drury,  Dr.  Russell,  and  Mr.  Yeldham  took  part)   .       U I 
6,  Retrospect  of  1862  .  .  .  .  .  ,  .144 

6.  Some  Unpublished  Letters  of  Hahnemann  .  .  .  .      IGo 

HOSriTAL. 

7.  On  some  Morbid  Affections  of  the  Nervous  System.    Lecture  I.— Epilepsy. 

By  Dr.  Russell      .  .  .  .  .  .  .  .164 

8.  Cases  treated  with  High  Dilutions.      By  S.  Yeldham,  Esq.,  Surgeon  to  the 

Hospital    .........      183 

9.  Cases  by  William  V.  Drury,  M.D.,  M.R.LA.,  Physician  Accoucheur  to  the 

Hospital  ....  ,  •  •      18S 


vi  Confnih. 


No.  XV. 


8i»(IHT. 


1.  A  Case  of  Kxtra  Uterine  Gestatiou.    L>y  Mr.  I.«eadam  .  .193 

2.  DiscDSfioD  (in  which  Mr.  Cameron,  Dr.  Drary,  and  Dr.  Qnin  took  part)  SOS 

3.  On  some  Morbid  Affections  of  the  Ear.       By   Charles   Cotmore,    E«q., 

M.R.C.L.,&L.M.,Eng.      .......  sio 

4.  Discussion  (in  which  Dr.  Drurj,  Mr.  Yeldhaui,  and  Mr.  Cameron  took 

part)         ......:..  236 

5.  A  Case  of  Hsmatnria  and  Albnminoria  after  Scarlatina  Miliaria.    Bj  Dr. 

Trinks       .........  228 

6.  Discussion  (in  which  Mr.  Teldham,  Dr.  Wjld  (of  London),  Dr.  Hughes, 

Dr.  Drury,  Dr.  Wilde  Cof  Winchester),  and  Mr.  Cameron  took  part)  241 

7.  Cases  of  Opthalmia,  with  Opacity  of  the  Cornea.     By.  Dr.  Ozanne  246 

8.  Some  Unpublished  Letters  of  Hahnemann              ....  254 


9.  On  some  Morbid  Affections  of  the  Nerroos  System.     Lecture  IL — Epilepsy. 

By  Dr.  Russell      ,.  ^  -  .  .  .  .  .       258 

10.  Cases  Treated  with  High  Dilutions.  By  S.  Yeldham,  Esq.,  Snrgeon  to  the 

Hospital     .........       283 

No.  XVI. 


1 .  Observations  on  the  Physiolo^iuai  aud  Therapeutic  Effects  of  Alcohol.  By 

Alfred  C.  Pope,  M.RO.S. 286 

2.  Discussion  (in  which  Mr.  Cameron,  Mr.  F.  H.  Smith,  Dr.  Dmry,  Dr.  Ru8«ell, 

Mr.  Yeldham,  and  Mr.  Pope  took  part)     .  .  .  .  .310 

3.  Case  of  Gangrena  Senilis.     The  last  illness  of  Archbishop  Whately.     By 

Dr.  Scriven  ........      318 

4.  Discussion  (in  which  Mr.  Yeldham,  Dr.  Kidd,  Dr.  Morgan,  Mr.  Buck,  Dr. 

Russell,  and  Dr.  Chapman  took  part)        .....       329 

5.  Observations  on  a  Few  Local  Anaesthetics.     By  Dr.  Eugene  Cronin  .      333 

6.  Discussion  (in  which  Dr.  Wyld,  Mr.  Cntmore,  Dr.  Drury,  Dr.  Russell,  and 

Mr.  Cameron  took  part)  ......       339 

HOSPITAL. 

7.  Lecture  on  Asthma,  by  Dr.  Russell  .....       342 

8.  Cases  Treated  with  High  Dilutions.     By  S.  Yeldham,  Esq.,  Surgeon  to  the 

Hospital   .  ,  ,  .  .  .  .  .  .       362 

AFPEl^DlX. 

Fourteenth  Annual  Report  of  the  London  Uomoeopathtc  Hospital       .  .371 


Contents.  vii 

No.  XVII. 

•OdBTT.  PAOB. 

1.  On  the  Alternations  of  Medicines.    ByDr.  Drjsdale         .  .871 

2.  Discnssion  (in  which  the  President  (Dr.  Qnin),  Mr.  Yeldham,  Dr.  Metcalf, 

Mr.  Reynolds,  Dr.  Chepmell,  Dr.  Dmry,  Mr.  J.  Harmer  Smith,  Dr.  Hale, 

Dr.  Russell,  Dr.  Drysdale,  and  Dr.  Chapman  took  part)    .  .  .      384 

3.  Notei  on  the  Symptoms  of  Cerebral  Disease.     By  Dr.  Black  .  .      404 

4.  Diacaesion  (in  which  Dr.  Drury,  Dr.  Wyld,  Dr.  Hughes,  Dr.  Eidd,  Mr.  J, 

Harmer.Smith,  Dr.  Russell,  Dr.  Black,  and  Dr.  Chapman  took  part)         •      424 

5.  On  Diabetes  Mellitus.     By  Dr.  Neaiby      .  .  .  .  .432 

6.  Discussion  (in  which   Mr.  Buck,  Dr.  Watson,   Dr.   Hamiltooi  and   Dr. 

Neatby  took  part)  .......      455 

7.  Resolutions  of  the  Society  in  regard  to  holding  Profesaional   Intercourse 

with  Unqualified  Practitioners      ......      453 


8.  Cases  Treated  with  High  Dilutions.     By  S.  Yeldham,  Esq.,  Surgeon  to  the 

Hospital  ........       460 

No.  XV lU. 

fiOGIBTT. 

O-,    1.  OnAlbWnuria.     By  Dr.  Gibbs  Blake       .....       487 
'    2.  Discussion  (in  which  Dr.  Drury,  Dr.  Bayes,  Mr.  Leadam,  Dr.  Ransford, 

Mr.  Theobald,  and  Dr.  Russell  took  part)  ....       485 

3.  A  Few  Remarks  on  the  Action  of  Hydrastis  Canadensis  in  Cancer.     By 

Dr.  Brtyes.  ........      489 

4.  Discussion  (in  which  Dr.  Drury,  Dr.  Hamilton,  Dr.  Metcalfe,  Mr.  Reynolds, 

and  Dr.  Hall  took  part)    .......      AOO 

5.  Remarks  on  Recent  Cases  of  Poisoning  by  Calabar  Beans.     By.  Mr.  J. 

Harmer  Smith     ........       602 

6.  Observations  on  the  Cactus  Grandiflorus.     ByDr.  Rubini  .  .       508 

7.  Discussion  (in  which  Dr.  Russell  and  Dr.  Yeldham  took  part)        .  .      512 

HOSPITAL. 

8.  Lecture  on  Asthma.    By  Dr.  Russell     •     .  .  .  .  .511 

9.  Cases  Treated  with  Low  Dilutions.    Bj  S.  Yeldham,  Esq.,  Surgeon  to  the 

Hospital    .........       533 

Index  to  the  Third  Volume      .  .  .  .  .  .  .543 


genitals  af  Ij^t  Somlg* 


IS  THE  DOCTRINE  OF  INFINITESIMALS  CONSISTENT 
WITH  EEASON  AND  EXPEEIENCE  ? 

By  Dk.  Samuel  Cockburn. 

Mr.  Chairman  and  Gentlemen, — ^Next  to  the  law  of  Cure, 
the  subject  of  Dose  occupies  the  most  important  position  in 
the  practice  of  Homoeopathy.  In  regard  to  the  law  we  are  all 
united,  and  herein  lies  our  strength — therein  lies  our  power. 
In  regard  to  the  dose  we  are  sadly  disunited,  and  herein 
lies  our  weakness — ^weakness  within,  deficiency  of  power 
without. 

I  confess  that  I  have  found  great  difficulty  in  knowing  how 
to  face  this  subject.  At  one  time  it  has  assumed  the  appear- 
ance of  an  immense  giant,  whose  vast  proportions,  armed  cap-a- 
pie,  struck  awe  to  one*s  heart,  and  defied  any  attempt  at  attack. 
At  other  times  it  has  assumed  the  appearance  of  a  phantom, 
to  fight  with  which  would  be  like  a  man  fighting  with  his  own 
shadow.     Giant  or  phantom,  let  us  face  it. 

In  order  to  take  a  comprehensive,  and  at  the  same  time,  a 
clear  and  definite  view  of  the  subject,  I  shall  divide  it  into 
eight  short  heads ; — 

I.  The  Origin  and  Tendency  of  Infinitesimals. 
II.  Infinitesimals  not  Demanded  by  the  Bequirements  of 
our  Organization. 

III.  Why  they  Cure,  and  Why  they  Cause  Aggravations. 

IV.  Tested  and  Found  Wanting. 

V.  The  Cause  of  Disunion,  and  an  Obstacle  to  our  Progress. 
VI.  The  Doctrine  of  Infinitesimals  is  Unscientific : 

1.  Because  Incomprehensible. 
VOL  m.  1 


2  Is  the  Doctriiu  of  InfinitesimaU 

2.  Because  Impracticable. 

3.  Because  Uncertain. 

VII.  The  Doctrine  of  Infinitesimals  is  opposed  to  and  sub- 
versive of  Homoeopathy. 
VIII.  The  Doctrine  involves  an  Absurdity. 
[As  this  paper  is  somewhat  too  long,  I  shall  be  obliged  to 
omit  some  portions  of  it] 

I. — ^The  Origin  and  Tendency  of  Infinitesimals. 

Hahnemann  is  silent  as  to  the  causes  which  led  him  to  the 
introduction  of  infinitesimals.  Why  he  did  so,  therefore,  can 
only  be  inferred  from  collateral  evidence.  What  led  him  to 
the  discovery  of  Homoeopathy,  and  the  evidences  of  its  truth, 
are  given  with  openness  and  candour.  What  led  him  to  the 
introduction  of  infinitesimals,  he  kept  a  secret.  The  difference 
between  Homoeopathy  and  the  old  method  of  practice  was  not 
so  great  as  that  subsisting  between  the  infinitesimal  doses 
which  he  invented  and  those  used  in  ordinary  practice. 
Homoeopathy  was  known  before,  and  had  been  practised  in  a 
limited  form  for  ages ;  but  infinitesimal  doses,  such  as  those  in- 
vented by  Hahnemann,  and  practised  by  some  of  his  followers, 
were  never  heard  of  before — ^never  had  any  existence.  It 
is  currently  admitted  that  he  was  led  to  diminish  his  doses  on 
account  of  the  aggravations  which  were  sometimes  observed 
to  follow  their  use.  This  reason  has  very  generally  been 
received — and  naturally  enough — though  no  one  has  ever 
alleged  that  these  doses  failed  to  effect  cures.  But  to  avoid 
aggravations  could  not  be  the  reason  for  the  introduction  of 
infinitesimals.  We  can  understand  how  a  large  dose  should 
give  place  to  a  small  one,  if  the  former  appeared  to  act  too 
powerfully — how  half-a-grain  should  be  given  in  place  of  a 
whole  grain,  or  a  quarter  in  place  of  a  half,  and  so  on ;  but 
we  can  see  no  relationship  whatever  between  any  degree  of 
aggravation  ever  recorded,  and  the  infinitesimal  dilution  of 
the  drug  frequently  used  oow.     And  then  you  wiU  observe 


Consistent  with  Reason  and  Experience  f  3 

that  it  was  not  in  all  the  cases,  not  even  in  the  majority  of  the 
cases,  that  any  unpleasant  aggravations  were  produced  by  the 
large  doses :  it  was  only  in  a  few  of  them,  in  which  monstrous 
doses  of  powerful  drugs  were^given,  that  anything  of  the  kind 
was  observed ;  but  the  infinitesimal  invention  applied  to  every 
kind  of  medicines,  whether  aggravations  had  ever  been  observed 
by  their  use  or  no.  And  then  Hahnemann,  as  well  as  many  who 
bear  his  name,  afl&rm  that  aggravations  happen  more  frequently 
under  the  use  of  infinitesimals  than  by  the  use  of  large  doses, 
thus  stultifying  the  original  reason  assigned  for  their  introduc- 
tion. I  therefore  cannot  believe  that  this  had  anything  to  do 
with  the  origin  of  these  doses.  There  are  only  two  alterna- 
tives— either  that  Hahnemann  was  not  led  to  the  introduction 
of  infinitesimals  fipom  the  fear  of  causing  aggravations,  but  for 
some  other  reason;  or  that  the  introduction  has  proved  a 
failure, — for  aggravations  occur  more  frequently  under  the  use 
of  infinitesimals  than  by  the  use  of  large  doses. 

As  is  well  known,  Hahnemann,  after  discovering  the  Homoeo- 
pathic law,  established  its  truth  by  a  record  of  facts  drawn  from 
the  experience  of  Allopathic  practitioners,  who,  of  course,  had 
effected  their  cures  by  the  use  of  large  doses.  His  faith  in  the 
truth,  therefore,  and  consequently  in  the  superiority  of  Homoeo- 
pathy over  Allopathy,  was  based  on  results  obtained  by  the 
use  of  such  doses.  And  when  he  commenced  to  follow  the 
law  in  his  own  practice,  he  not  only  had  no  intention  of 
giving  doses  different  from  those  generally  given  by  Allopaths, 
but  daily  experience  with  such  doses  confirmed  and  estab- 
lished his  faith  in  their  success.  Small  and  infinitesimal 
doses  were  then  never  dreamt  of.  For  nine  years  he  practised 
Homoeopathy  with  the  large  doses  of  crude  drugs  used  by  Allo- 
paths, and  by  these  obtained  cures  which  for  rapidity  and 
beauty  have  never  been  surpassed.  His  success  then  was 
the  making  of  Homoeopathy.  Every  year's  experience  with  these 
doses  gave  fresh  proofs  that  Homeopathy  was  true ;  and  every 
year  raised  him  in  public  estimation  as  a  successful  practi- 


4  Is  the  Doctrine  of  Infinxtenmah 

tioner.  In  1799,  his  fame  and  reputation  ran  so  high  as  to 
attract  the  notice  and  arouse  the  jealousy  of  the  medical 
authorities  in  Wolfenbiittle,  where  he  then  resideil.  And  as 
Halinemann's  practice  of  dispensing  his  own  medicines  was  a 
direct  violation  of  a  national  law,  which  nia<le  it  ini[)erative  on 
every  medical  practitioner  to  have  his  medicines  prepared  and 
dispensed  by  an  apothecary,  an  action  was  raised  against  him 
by  the  apothecaries,  whose  privileges  he  had  infringed  upon. 
The  result  of  this  was,  that  Hahnemann  was  debarred  from 
practising.  All  who  have  studied  the  nature  of  the  struggle 
between  the  great  Medical  Eeformer  and  the  apothecaries,  must 
have  observed  that,  to  a  very  considerable  extent,  Hahnemann's 
feelings  got  the  better  of  his  judgment.  As  an  intelligent 
man,  Hahnemann  must  have  felt  that  his  case  with  the  apothe- 
caries was  a  hopeless  one.  They  had  the  strong  arm  of  the 
law  on  their  side ;  he  had  none.  How,  at  this  period,  he  rea- 
soned on  the  subject,  we  know  not ;  but  the  very  next  year 
after  this  attack  upon  him  by  the  apothecaries,  we  have  the 
first  introduction  of  the  infinitesimals.  We  have  not  the  gradual 
diminution  in  the  size  of  the  dose  which  we  would  naturally 
have  expected  to  find  in  the  development  of  a  new  practical 
fact,  but  the  sudden  and  unlooked-for  introduction  of  infinitesi- 
mals. And  he  on  more  than  one  occasion  afterwards  pointed 
to  these  infinitesimals  as  a  triumph  over  the  apothecaries,  whose 
services  in  future  would  not  be  required  by  medical  practitioners, 
and  whose  trade  would  therefore  be  ruined.  Under  cover  of 
these  infinitesimals,  he  endeavoured  to  evade  the  law ;  and  some 
years  after  that  brought  out  his  famous  manifesto  in  defence  of 
his  position,  in  which,  by  a  species  of  special  pleading  which 
no  one  can  approve  of,  he  endeavoured  to  show  that  the  law 
did  not  and  could  not  apply  to  his  peculiar  kind  of  medical 
practice. 

Looking  at  these  facts,  I  think  we  have  veiy  strong  evi- 
dence to  suspect  that  the  persecution  referred  to  had  something, 
if  not  everything,  to  do  in  originating  the  infinitesimal  doses. 


Consistent  with  Reason  and  Experience  f  5 

II. — Infinitesimals  not  Dbmandkd  by  the  Kbquieembnts 
OF  ouB  Organism. 

In  every  condition,  in  every  circumstance  of  human  exist- 
ence, in  savage  equally  as  in  civilized  life,  the  body  can  appro- 
priate for  its  support  and  growth  only  those  substances  which 
in  their  constitution  correspond  to  itself.  Qualitative  resem- 
blance is  an  absolute  necessity ;  every  departure  from  this  frus- 
trates the  ends  of  nutrition  and  growth.  But  while  qualitative 
resemblance  is  so  imperative,  absolute  quantitative  relationship 
is  not  so.  Man  is  so  constituted  that,  provided  he  gets  what 
is  in  its  nature  suitable,  it  is  not  necessary  that  he  should 
take  it  in  such  a  quantity  that  it  shall  not  by  one  grain,  or  by 
one  fraction  of  a  grain,  be  above  or  below  a  certain  given 
standard.  He  lives,  grows,  and  thrives  on  quantities  and 
proportions  varying  to  a  very  considerable  and,  in  some  in- 
stances to  a  very  great  extent.  Were  this  not  the  case,  and 
if  every  fraction  of  a  grain  either  in  our  bread,  salt,  or  beef, 
were  to  be  followed  by  loss  or  suffering,  what  would  our  lives 
be  ?  We  cannot,  could  not  by  any  means,  know  exactly  to  a 
grain  how  much  we  need,  and  no  more ;  and  if  this  is  so,  how  much 
less  could  we  know  to  the  hundredth,  thousandth,  or  millionth 
part  of  a  grain  the  exact  quantity  we  need  ?  God  has  so  formed 
our  bodies,  that  we  don't  need  to  know  this ; — ^practically,  such 
knowledge  would  be  of  no  use.  That  man  would  be  recognised 
as  a  madman  who  should  attempt  to  regulate  his  food  by  the 
grain ;  much  more  so,  were  he  to  estimate  it  by  miUionths  or 
billionths. 

The  cure  of  disease  can  only  be  effected  by  a  remedy  having 
a  certain  definite  relationship  to  the  disease.  Whatever  the 
form,  whatever  the  condition, — ^be  it  plant,  mineral,  or  metal, — 
this  qualitative  relationship  is  imperative.  This  qualitative  rela- 
tionship discovered  and  established  by  Hahnemann,  we  recognise 
by  the  teim  Homoepathy.  In  all  ages  of  the  world — ^in  every  con- 
dition of  human  existence,  civilized  and  savage — througkow^*  viSi 


6  Is  the  Doctrine  of  Infinitesimals 

the  reigns  of  diflTerent  and  opposing  medical  theories  and  systems, 
cures  have  been  eCTected  in  accordance  with  this  qualitative  rela- 
tionship, and  by  quantities  varying  as  much  as  we  find  to  obtain 
in  the  quantities  of  food  used  by  different  individuals.  Our  pre- 
sent knowledge  of  the  history  of  medicine  has  brought  this  con- 
sjiicuously  to  light.  Large  doses  have  cured,  and  do  still  cure. 
Small  doses  have  cured,  and  do  still  cura  A  man  may  take  too 
much  of  the  right  kind  of  food,  and  an  abnormal  and  uncom- 
fortable condition  of  obesity  ensue ;  or  he  may  take  a  great  deal 
too  much,  and  die  from  gluttony ;  or,  again,  he  may  take  too 
little,  and  the  energy  and  strength  of  the  system  become  im- 
poverished ;  or,  he  may  take  a  great  deal  too  little,  and  die  fipom 
starvation.  But  between  death  from  gluttony  and  death  from 
starvation  there  is  a  wide  range  of  degrees,  and  the  right  and 
the  i)roi)er  are  easily  found  by  the  great  majority  of  mankind. 
But  that  the  right  and  the  proper  are  comprised  within  limits 
so  marked,  tliat  the  passing  of  which  on  the  one  side  or  the 
other  must  entail  suffering  or  loss,  is  not  true.  In  the  best  of 
health,  our  frxxl,  in  quantity,  varies  within  certain  conservative 
limits,  wliich  have  a  considerable  range  every  day,  and  that 
variation  has  no  effect  upon  us.  The  constitution  of  our  bodies 
is  wondorfiiUy  and  beautifully  adapted  to  this. 

And  just  so  in  disease — a  patient  may  take  too  much  of  the 
riglit  kind  of  medicine,  and  thereby  produce  disturbing  drug 
syniptoiriH;  or  he  may  take  a  great  deal  too  much,  and  die  in 
coriH(jquorice ;  or,  again,  he  may  take  too  little,  and  the  disease, 
unolKjckod,  may  extend  its  ravages  in  the  system;  or  he  may 
tak(i  far  too  little,  and  die  from  the  disettse.  But  between  death 
from  drug  jioisoning  and  death  from  too  little  medicine  there 
is  u  wi(l(j  lunge  of  quantities,  within  which  range  we  are  sure 
in  (jflciciiiig  a  cure,  and  within  which  we  are  quite  as  certain  of 
doing  no  liann.  Infinitesimal  quantities  of  the  right  kind  of 
food  are  bcjyond  our  capacities  to  appreciate,  and  unnecessary. 
IrifinitcHinial  qiuintitics  of  medicine  are  also  beyond  our  capa- 
cities to  appreciate,  and  in  the  cure  of  disease  are  qidte  un- 


Consistent  with  Reason  and  Experience  t  « 

necessary.  The  body,  to  live  and  grow,  must  have  food ;  dis- 
ease, to  be  cured,  must  have  medicine.  To  say  that  exactly  so 
many  grains  or  so  many  drachms  or  ounces  ought  to  be  taken, 
and  no  more,  would  be  no  more  absurd  than  to  say  that  the 
billionth  or  trillionth  of  a  grain  was  the  only  right  quantity 
to  cure.  The  speculative  theory  which  would  defend  the  one 
figment  would  equally  apply  in  defence  of  the  other  phantom. 
Let  us  be  men  guided  by  the  real  and  the  true.  Science  deals 
with  the  known  and  knowable. 

III. — ^Why  they  Cube,  and  Why  they  cause  Aggravations. 

It  would  be  absurd  to  deny  that  aggravations,  and  aggrava- 
tions of  a  very  violent  description,  have  taken  place  during  the 
use  of  infinitesimal  doses.  Authenticated  facts  of  this  kind, 
from  a  variety  of  sources,  place  the  subject  beyond  all  doubt. 
But,  seeing  that,  comparatively  speaking,  large  doses  of  the 
same  medicine  used  in  similar  diseases  do  not  produce  the 
aggravations  which  are  assigned  to  the  infinitesimals,  it  is 
evident  that  there  must  be  some  special  reason  to  account  for 
the  fact.  It  is  not  difficult  to  understand  how  the  fourth 
of  a  grain  produces  less  effect  than  a  whole  grain,  and  how  the 
fiftieth  part  produces  stUl  less ;  but  that  the  ten  thousandth 
part  of  a  grain,  or  a  billionth  part,  should  produce  a  greater 
effect  than  the  whole  grain,  cannot  be  understood  without  the 
introduction  of  some  special  reason  to  account  for  the  fact. 
How  do  infinitesimals  produce  aggravations?  Some  years 
ago  I  more  than  once  met  with  patients  who  complained  sadly 
of  having  been  much  disturbed  by  the  medicines  they  were 
taking,  the  symptoms  of  their  complaint  having  been  much 
aggravated,  and  who  declared  that  they  could  not  possibly  con- 
tinue to  use  it  on  account  of  its  over-powerful  action.  This 
annoyed  and  puzzled  me  for  a  long  time,  more  especially  as 
the  medicines  then  used  were  in  infinitesimal  doses  from  the 
6th  to  the  12th  potency,  and   sometimes  higher.     The  fact 


5  Is  the  Dortrinf  of  InfinittMmaU 

:i..\:  ctl.ers  had  often  met  with  similar  cases  did  not  in  any 
irjTv-r  Iv^son  the  difficulty.  Tu  sjiite  of  my  own  exj^erionce 
az.:  ::..;:  of  many  others,  the  farts  set'ined  to  me  to  involve  a 
:::.:rA.l:::i..a.  and  I  resolved  on  tryin;^  s«jme  exi>eriment«  in 
:r.'.-.r  :■:  J.v:emiine  their  meaning.  To  one  patient  who  com- 
^*.i::.v.l  loudly  of  his  mahuly  having  l»een  aggravate<l,  and 
ii^  r:>>:\:  strong  fears  that  the  honueoj^athic  medicine  was  too 
r«."3-rr:j.l,  I  gave  powders  of  pure  sugar  of  milk,  and  the  aggra- 
Ti::::ij  weiv  quite  as  strongly  nuirked  as  Wfore.  To  another, 
L  ifni.CT.  who  complainetl  of  Ixiing  much  disturbed  by  the 
n-i'i:.!::*  I  gave  pure  water,  with  a  few  droi>s  of  spirit  of  wine 
ii.  ::.  i::I  s::ll  the  aggravations  continueil.  In  two  or  three 
:•:!  fr  -.'i^s  I  loUoweii  the  s;une  plan,  and  with  the  same  results, 
iLf  £.c:-:T'.v;i:£oas  Knng  ijuite  as  much  under  the  sugar  of  milk 
ijil  >\  :t::  .*:  wine  as  under  the  globules.  These  facts  forced 
n-:  :.'  .vz.lnde  that  the  aggravations  were  not  pnxluced  by 
:!-■  ^'.V::>s  a:  all.  but  aiv>$e  from  a  cause  witliin  the  patient 
l:r-:5rl; — hii  a  subjective  origin.  I  ivmeml^r  two  of  these 
ri>-^  :u  yA:t:.",:lAr.  the  patient*  having  left  me  altogether,  de- 
^jiTLT^  :h^y  ivul.i  &>:  stand  the  tiwitment 

Sur..^'  li?;:-  1  hive  me:  with  similar  cases^  and  have  followed 
±r  -:i:,:>->  ry^\>K:e  plan  to  that  ivferrevl  ta  In  place  of  giving 
x-rr:  --:i:~>  rvce::iL«vi  d^v^es.  or  puiv  sugar  of  milk.  I  have 
Ti^cr  LZ  ,-i::j.v,  or  in  ;^>iuo  C5is<>s  gradually,  come  down  to 
x.i^zr:jLl  :rSi,':-.-ciAl  di\i^^  of  the  uuxli^ino  which  was  found  to 
.-sii-s:  -.1-  i^riV3i:va.  and  in  all  suoh  oas^>s  1  have  found  the 
Acr^  -i~.-3:  T,'  >rtjfca^  ray:a:Y.     1  n<\\i  no:  ciil^rp?  on  this^ 

Yrn  -J:*:>s*f  rv\^  ^r.T!«  of  ex^^vriiuoutcv  1  a:u  ^viiviuced  that 
iZ,  *c^  '"i-.\irs  A.vzrt*j:i:  vixxTti;^:  t!:e  use  of  ir,t::u:e??™ils^  which 
ijv  r  :  ri^jLTsI  5fTwroc2::^;rri:*  \>f  iho  o.:si<\-Uk\  r.::v>AvkTxi  >y  che 
-r-=L:=-=u~   ij^  yzr.xriL-rt;  ?>f  jci  iv,iprt>*3Uon  v/,Av:e  vn:  :he  iiiagi- 

Z-Zi-  >  i:?  i  T^.  «a\£  ^wiilN  thN>*i*  who  tlrs:  s.v:t:<'  r:n%ier 
:l=l-i-. -!.::_-■.  T^scir^is:::  iit'^'s?  r>;>5  the  faiutxx:^:  id^  o:  wbai 
^:=rrj.'TiiL'i^\:  ^srs^he^  >yn5«s».  either  a*  iv^yxU  their  iubenrnt 


Consistent  vnth  Reason  and  Eocperience  t  9 

properties  or  their  strength.  The  name  of  the  remedy  and  the 
name  of  the  potency  make  him  in  reality  no  wiser.  In  this 
condition  of  ignorance  it  is  natural  that  certain  individuals 
should  expect  to  experience  some  imdefined  kind  of  effect  im- 
mediately on  taking  a  dose  of  those  mysteriously  powerful 
drugs,  of  which  probably  they  have  heard  some  strange  stories. 
And  further,  it  is  not  only  natural,  but  it  is  certain,  that  the 
impression  thus  formed  on  their  imagination  will  manifest 
itself  in  the  direction  of  the  morbid  condition  imder  which  the 
patient  is  suffering,  and  that  it  will  manifest  itself  either  as  a 
special  aggravation,  or  as  a  modification  of  the  existing  malady. 
It  is  also  quite  certain  that  an  alleviation  of  the  complaint 
may  be  produced  in  the  same  way,  and  it  may  even  happen 
that  a  curative  result  takes  place  after  the  previous  aggrava- 
tion. Sudden  and  strong  mental  impressions  have  often  pro- 
duced very  serious  diseases,  and  even  death,  and  they  have 
also  often  produced  miraculous  cures.  This  is  admitted  by  alL 
That  the  aggravations  in  the  cases  referred  to  did  actually 
arise  from  an  influence  having  a  subjective  origin  cannot  be 
doubted,  seeing  that  the  aggravation  ceased  so  soon  as  a  suffi- 
cient quantity  of  drug  was  taken  to  produce  a  real  drug  action. 
As  the  excited  imagination  has  the  power  of  impressing  itself 
on  the  existing  disease,  and  thereby  producing  aggravation ;  so 
the  drug  has  the  power  of  impressing  its  action  on  the  sensitive 
sphere,  quite  independent  of  the  imagination,  and  thereby  the 
patient  becomes  conscious  merely  of  a  slight  drug  action — so 
slight,  indeed,  as  may  merely  suffice  to  counteract  the  effect  of 
the  imagination  and  alleviate  the  malady. 

Those  who  wish  to  cure  disease  by  acting  on  the  imagination 
will  find  the  30  th  or  any  higher  potency  a  most  suitable  dose, 
there  being  no  fear  of  such  doses  interfering  in  any  way  with 
either  biological  or  magnetic  influences.  But  those  who  believe 
that  drugs,  when  properly  given,  have  the  power  of  curing  all 
curable  diseases,  should  see  to  it  that  in  the  treatment  of  dis- 
ease they  are  really  using  drugs,  and  not  mere  names. 


10  Is  th€  Doctrine  of  InJiniiesimaU 

IV. — Tested  and  Found  Waitting. 

Hahnemann  recommended  globule  doses  of  the  SOth  attenu- 
ation as  being  the  most  highly  curative  potency  and  dose  of 
the  drug.  True,  ho  substituted  olfaction  in  place  of  the 
globule  in  his  latter  years ;  but  as  this  part  of  Ilahnemannism  is 
not  formally  represented  in  our  day,  we  need  not  consider  it. 
Many  have  gone  far  beyond  their  teacher  in  the  potentizing  pro- 
cess, the  200th  being  frequently  used  by  soma  Some  choose  the 
high  potencies ;  some  choose  the  low ;  and  some,  again,  with  an 
accommodating  profession  of  extreme  liberality,  choose  all — 
high  and  low,  low  and  high,  up  and  down,  down  and  up, — 
guided  by  what  ?  Yes,  by  what  ?  Will  anyone  tell  me  why 
he  chooses  the  SOth  in  place  of  the  29tli  or  28th ;  or  why  he 
chooses  the  60th  in  place  of  the  Gist,  or  the  12th  in  place  of 
the  13  th,  and  so  on  ?  What  is  his  guide  in  choosing  these  ? 
It  cannot  be  experience,  for  most  of  the  intermediate  potencies 
he  has  never  tried,  and  in  all  likelihood  never  will  try.  Do 
we  call  our  friends  over  the  way  routinists?  What  is  the 
choice  of  the  SOth  potency  but  the  highest  embodiment  of 
routinism  ? 

There  appears  to  me  but  one  way  of  fairly  and  conclusively 
testing  the  worth  of  these  infinitesimals,  and  that  is,  to  try 
them  in  such  cases  as  shall  leave  no  doubt  as  to  the  effect  of 
the  treatment  upon  the  disease.  Some  complaints  are  very 
capricious  in  their  course  and  development,  paroxysms  of  pain 
coming  on  suddenly  without  any  intimation,  and  often  going 
off  as  suddenly — old  troublesome  symptoms  reappearing  under 
influences  which  we  cannot  always  understand — abnormal  con- 
ditions, changes  of  mode  of  living,  changes  of  weather, 
atmospheric  changes,  &c.,  remaining  away  for  years,  or  re- 
turning in  some  new  form.  It  is  clear  that  it  would  not  be 
fair  to  test  these  doses  in  such  complaints,  because  there  might 
be  room  to  doubt  whether  the  dose  given  really  had  anything 
to  do  with  the  change  that  took  place  during  its  use.     There 


Consistent  with  Reason  and  Experience  f  11 

are  some  complaints,  however,  the  natural  course  and  history 
of  which  we  know  so  well  that  we  can  be  certain  as  to  the 
effect  of  the  treatment.     I  shall  refer  to  one  or  two  of  these. 

Thus,  in  hooping  cough,  Hahnemann  recommends  one 
globule  of  the  30th  potency  of  Drosera,  which  he  says 
will  cure  the  malady  in  seven  or  eight  days.  like  all  of  you, 
I  have  had  many  opportunities  of  testing  the  truth  of 
Hahnemann's  assertion  on  this  point,  and  I  have  no  hesitation 
in  saying  that  even  in  very  simple  uncomplicated  cases,  I  have 
not  observed  the  slightest  effect  from  the  use  of  globules  of 
the  30th  potency  of  Drosera,  even  after  trying  it  for  a  longer 
period  than  seven  or  eight  days.  I  have  also  consulted  many 
authorities  on  the  treatment  of  this  complaint,  and  the  whole 
weight  of  testimony  is  dead  against  the  eflftcacy  of  globules  of 
the  30  th  potency.  Drop  doses  of  the  1st  cent,  of  Drosera  I 
have  often  seen  do  good,  though  no  one  now  trusts  to  this 
medicine  as  the  specific  for  every  kind  of  hooping  cough. 
Hahnemann's  reconmiendation  of  the  30th  potency,  and  his 
assertion  about  curing  it  in  seven  or  eight  days,  can  only  be 
looked  upon  as  the  offspring  of  his  theory,  and  is  very  much 
of  a  piece  with  the  monstrously  exaggerated  statement  he 
makes  about  one  drop  of  the  1 5th  potency  being  sufficient  to 
endanger  the  life  of  a  child.  Hooping  cough  in  a  mUd  form 
disappears  of  itself,  but  globules  of  the  30th  potency  of 
Drosera  have  no  effect  upon  it. 

In  the  treatment  of  itch,  also,  Hahnemann  says  that  one 
globule  of  the  30th  potency  of  sulphur  is  sufficient  to  effect  a 
cure.  Hahnemann's  method  has  been  tried  times  without 
number,  and  found  a  failure.  Now,  itch,  whether  of  recent  or 
longstanding,  cannot  be  cured  by  globules  of  the  30th  potency 
of  sulphur.  The  testimony  of  the  profession  is  clear  and  ex- 
plicit on  this  subject ;  and  it  is  highly  questionable  if  Hahne- 
mann himself  ever  did  any  good  by  it,  or  even  tried  it.  We 
have  it  on  the  testimony  of  Dr.  Hartmann  that  Hahnemann 
did  not  abide  by  the  treatment  he  recommended  to  others.     Iil 


1  2  I A  thf  Dortrinf  of  InJinUesimaU 

181G,   t\v«Mily-six  ywirs  nftor  the  discoveiy  of  HomcDopathr, 
nii«l    sixt<*(>ii    yoiirs    at'trr  tlie   iiiv(*iition  of  infinitesimals.  Dr. 
Ilartiiiaiiirs    bpitlirr    Applied  to   Hahnoinann  for  the  cure  of 
itch.      IlaliiH'inann,  of  course,  nrniiniiriidod  sulphur,   but  not 
one  ^'Iiilmlo  of  the  3()th  jMitiMuy — no,  hut  the  1st  decimal,  and 
tliat  lint   in  ;^h)hu1o  doses,  hut  as  nnuh   as  would  cover  the 
])oiiil  of  a  iKMiknifo;   and  not  onro  a  fortnight,  but  three  times 
a  (hiy.     And,  besides  that,  sulpliur  ointment  was  to  be  rubbed 
into  the  joints  every  ni^ht.     This  eminently  rational  treatment 
was  ]»erfe<'tly  suc(;e8sful ;  Hartniann's  bnjther  was  cured,   and 
enjoyed  perft^ct  health  afterwanls.     This  one  fact  upsets  all 
Hahnemann's  theorisings  alxjut  the  cure  of  itch  by  four  globules 
of  the  30tli  potency. 

In  s}^hilitic  diseases,  Hahnemann  asserts  that  one  globule 
of  the  30  th  potency  of  mercury  is  sufticient  for  the  cure.  I 
need  scarcely  say  that  this  assertion  has  been  disproved. 
Evidence  from  every  part  of  the  world  testifies  that  the  30th 
potency  of  mercury  has  no  effect  on  this  disease;  and  the 
practice,  if  followed  out,  would,  to  a  certainty,  be  productive 
of  the  most  dire  and  destructive  consequences. 

Then  in  cholera,  the  universal  voice  of  the  profession  is 
against  globules  of  the  30th  potency.  Even  Hahnemann's 
treatment  of  this  disease  with  camphor,  was  heroic  when  com- 
pared to  that  of  all  other  Homceopathists  now-a-days.  Large 
quantities  of  the  saturated  tincture  were  given  internally ;  the 
same  was  given  as  an  enema,  and  also  rubbed  largely  all  over 
the  body.  Why  in  this  disease  should  the  potentizing  theory 
not  hold  good  ? — ^why,  if  the  curative  power  of  the  camphor 
is  more  highly  developed  by  the  potentizing  process,  why  not 
use  the  drug  in  its  most  highly  curative  form  in  this  highly 
dangerous  disease  ?  It  is  in  rapid  and  dangerous  diseases  that 
we  require  the  highest  resources  of  the  medical  art.  Why, 
if  potentized  drugs  are  best,  do  we  not  give  the  30th  potency 
of  camphor?  In  this  case  theory  has  failed  to  crush  and 
rule  over   the   good   sense    of  Hahnemann   and  that  of  his 


Consistent  with  Reason  and  Experience  i  13 

followers ;  and  it  is  a  blessing  to  the  world  that  such  has  been 
the  case. 

Is  there  any  reason,  in  the  nature  of  the  case,  why  the  30th 
potency  should  not  be  given  ?     Let  us  see. 

First,  in  regard  to  the  disease : 

(a.)  It  cannot  be  because  of  the  danger  and  fatality  of  the 
disease,  because  there  are  many  other  dangerous  and  fatal  dis- 
eases in  which  the  30th  potency  is  given.  According  to 
Hahnemann's  theory,  the  severity  of  the  complaint  does 
not  regulate  the  potency,  were  it  the  case  that  the  danger 
and  urgency  of  the  disease  is  to  be  the  guide,  as  to  the  strength 
of  the  dose;  it  would  be  an  amusing  application  of  the 
Eule  of  Three  to  find  out  what  degree  of  severity  or  danger 
any  particular  disease  would  require  to  have  to  be  treated  by 
the  30th  potency,  that  of  another  being  given  which  required 
drop  doses  of  the  saturated  tincture.  Such  a  disease  would 
certainly  be  very  highly  attenuated. 

(6.)  It  cannot  be  because  the  disease  is  one  which  runs  a 
very  rapid  course ;  for  we  do  not  find  this  principle  at  all 
acknowledged  or  acted  upon  by  strict  Hahnemannians.  Diseases 
running  their  course  in  a  few  days  receiving  the  same  30  th 
potency  which  is  applied  to  others  extending  over  months  or 
years. 

Second,  in  regard  to  the  drug : 

(a.)  It  cannot  be  because  camphor  has  a  short  period  of 
action  in  the  body ;  for  this  would  account  for  the  frequency 
of  repetition,  but  not  for  the  strength. 

(6.)  It  cannot  be  because  the  drug  has  a  feeble  or  slight  action 
on  the  system;  for  camphor  has  a  powerful  action  and  in 
strong  doses  produces  alarming  and  fatal  results ;  an  action 
more  powerful  than  carbo.  calc.  cam.  silic,  &c.,  which  are 
given  in  the  30th  potency.  Why  then  not  be  consistent,  and 
follow  out  the  potentizing  theory  in  this  case?  I  look  to 
potentisers  to  give  the  answer. 

I  might  here  refer  to  gonorrhoea,  but  no  one  who  knows 


14  h  the  Doctrine,  of  InfiniUsimaU 

aiivtliint;  of  the  trimtmoiit  of  Ruch  complaints  imagine  that 
^luhiilis  of  tlio  3(»tli  iM»tt'iicy  have  any  effect  at  alL  If  then 
^Inhiilrs  of  tlio  3()th  potciu'V  of  the  tnio  carative  remedy 
art*  fouinl  to  he  iuo|M>r:itivc  in  those  complaints  mentioned,  what 
coiK-lii.sion  are  we  to  come  to  ?  Hahnemann  says  the  30th 
potcnry  is  the  most  hi^'lily  cunitivc  in  all  diseases,  but  what 
he  says  in  ref^^nl  to  the  general  use  of  the  30th  potency  has 
no  more  evi<If'ncc  to  su])iKirt  it  than  what  ho  says  in  regard 
to  its  special  eflicacy  in  hooping  cough,  itch,  and  syphilis. 
But  the  testimony  of  facts  jimves  that  the  30th  potency  has 
no  effect  in  these  s])C('ial  com])laints,  and  we  are  therefore 
warranted  in  concluding  that  it  lias  no  effect  in  general  use — 
no  effect  in  any. 

V. — ^The  Cause  of  Disunion,  and  an  Obstacle  to  our 

PUOGRESS. 

Homoeopathy,  as  a  principle,  can  be  demonstrated — ^proved  to 
be  true ;  and  when  fairly  examined,  it  has  commanded  the  assent 
of  every  intelligent  mind.  The  most  that  any  of  its  bitterest 
opponents  have  ever  ventured  on  saying  is,  that  while  true  in 
principle,  it  is  not  of  universal  application.  A  large  and  prac- 
tical knowledge  of  it,  however,  leads  to  the  conclusion  that  it  is 
universally  applicable  in  its  own  sphere.  As  a  general  truth, 
harmonising  with  the  highest  exercise  of  reason,  and  also 
with  the  results  of  experience,  it  is  designed  to  be  univer- 
sally acknowledged.  In  this  we  look  for  unity — a  unity 
quite  consistent  with  very  considerable  diversity  in  the  special 
individual  apprehensions  we  may  have  of  it.  It  is,  perhaps, 
impossible  for  any  two  minds  to  look  at  or  apprehend 
any  one  truth  in  every  aspect  of  it  exactly  in  the  same 
way.  Being  universal  in  application,  we  look  upon  it  as  being 
designed  to  become  universally  practised.  Absolute  unity  in 
practice  we  know  cannot  be ;  but  there  is  a  unity  of  practice  as 
well  as  a  unity  of  principle  quite  consistent  with  very  con- 
siderable difference  in  detail     We  look  forward  to  and  strive 


ConrnterU  with  Reaso'n  and  Experience  f  15 

for  a  universal  unity  in  practice.  Far  be  it  ftom  me  to  profess 
such  an  amount  of  liberalism  as  would  recognise  one  kind  of 
practice  just  as  good  as  another,  or  that  two  opposite  kinds  of 
practice  can  ever  possibly  be  true.  There  can  be  only  one 
law  of  healing,  and  only  one  true  mode  of  practica  Of  all 
the  systems  of  the  past,  no  one  has  ever  been  based  on  a  prin- 
ciple of  universal  application;  no  one  has  ever  harmonised 
the  relationship  between  drugs  and  disease ;  no  one  has  ever 
had  the  character  of  perfection  in  principle,  progressive 
development  in  application,  and  catholicity  in  spirit.  When 
properly  understood,  Homoeopathy  delivers  from  the  bondage 
and  thraldom  of  all  theories  and  dogmas,  and  gives  the  indi- 
vidual practitioner  a  key  and  a  guide  to  imlock  every  diffi- 
culty— to  cure  disease  with  safety  and  certainty,  if  faith- 
fully followed.  But  while  it  does  this,  it  involves  a  higher 
weight  of  individual  responsibility  than  any  other  system  ever 
did.  No  one  can  ever  be  a  true  Homoeopathist  who  is  guided 
by  the  opinion  of,  or  follows  in  the  footsteps  of,  another. 
The  law  must  be  his  only  guide — individual  right  and  privi- 
lege in  choosing ;  individual  responsibility  in  faithfully  acting ; 
no  casting  blame  on  leaders  or  teachers.  Along  with  this  indi- 
viduality of  choice  and  universality  of  application,  we  look  for 
unity  of  practice,  and  we  ought  to  hav^  it.  In  the  choice — 
in  the  selection  of  a  drug  for  a  special  disease,  we  have 
something  like  unity ;  thanks  to  the  definiteness  and  clearness 
of  the  law  for  this.  And  this  is  a  great  matter ;  but,  in  the 
dose  of  the  remedy,  in  its  application,  alas !  alas !  what  have 
we  ?  Unity  ?  E"o ;  but  the  wildest  confusion,'  the  most  ex- 
treme discord.  In  the  application  of  the  Homoeopathic  law, 
we  have  now  a  monstrosity  of  diversity  such  as  never  was 
heard  of,  never  conceived  of — a  diversity  and  a  confusion 
which  baffles  the  mind  to  grasp.  One  practitioner  gives  a 
drop  of  medicine,  another  gives  a  tenth  part;  one  gives  the 
hundredth  part,  another  gives  the  thousandth ;  one  gives  a  mil- 
lionth,   another   gives  the   billionth;    one  gives   a  trilliontb. 


16  Is  the  Doctrine  of  Injmitesimals 

another  the  quadrillionth,  and  so  on  and  so  on  without  an 
end,  to  a  region  requiring  a  new  phraseology — a  new  lan- 
guage, which  corresponds  to  no  conception  of  our  mind, 
and  which  we  cannot  understand.  What  is  the  value  of  such 
contradictory  experience  as  this  ?  What  is  the  meaning  of  all 
this  discord — all  this  confusion  ?  There  must  be  error  somewhere. 
No  wonder  our  opponents  have  looked  upon  Homoeopathy  as 
quackery  and  tomfoolery.  Can  anyone  approve  of  our  present  posi- 
tion in  this  respect  ?  Can  anyone  defend  it  ?  Can  anyone  desire 
it  to  continue  ?  Surely  not.  And  if  not,  what  is  to  be  done  ? 
The  triumphant  progress  of  Homcepathy  has  been  to  a  great 
extent  arrested;  and  the  precious  blessings  it  is  capable  of  dis- 
pensing have  been  to  a  great  extent  shut  up  from  a  suffer- 
ing world,  and  confined  to  a  narrow  and  limited  circle,  by  the 
extravagant  and  irrational  fancies  of  infinitesimal  potentisers. 
I  have  unbounded  faith  in  the  power  of  truth  reaching  the 
hearts  and  understandings  of  men,  if  rightly  advocated.  The 
opposition  to  Homoeopathy  by  the  great  majority  of  the  pro- 
fession has  not  been  against  Homoeopathy  proper,  but  against 
the  errors  and  abuses  that  have  been  mixed  up  with  it.  Let 
us  learn  a  lesson  from  the  past,  and  be  wise.  I  am  persuaded, 
if  Homoeopathy  had  been  rationally  practised  and  wisely  advo- 
cated, that  instead  of  hundreds,  we  would  now  have  been  able 
to  count  our  numbers  by  thousands.  We  look  for  this,  and  we 
ought  to  accomplish  it. 

Hahnemann  discovered  Homoeopathy,  but  Hahnemann  in- 
vented the  doctrine  of  infinitesimals.  There  is  a  limit  to  all 
human  greatness ;  there  is  always  a  something  to  mar  human 
glory.  Hahnemann  was  not  contented  to  be  a  discoverer,  and 
to  be  a  humble  servant  and  exponent  of  the  truth  which  he 
discovered,  but,  unfortunately,  he  set  himseK  up  as  a  leader. 
"  Unless  the  physician  imitates  my  method,"  and,  "  If  phy- 
sicians do  not  carefully  "^practice  what  I  teach,  let  them  not 
boast  of  being  my  followers."  Such  is  his  language.  Homoeo- 
pathy after  this  lost  its  catholicity.     In  place  of  being  a  gift 


Consistent  wUh  Reason  and  Experience  t  17 

from  (tocI  Himself  to  a  suiSeriiig  world,  suited  for  all  men  and 
all  times,  it  became  marred  like  clay  in  the  hand  of  the 
potter,  and  became  stamped  with  the  characteristics  of  the 
man ;  and,  as  a  consequence,  we  have  actually  a  controversy 
between  the  claims  of  Hahnemann  and  Homoeopathy.  This 
was  his  error;  here  he  fell.  And  how  many  have  fallen  here ! 
As  a  leader,  he  invented  the  infinitesimals,  and  imposed  them 
upon  his  followers,  making  the  adoption  of  these  a  test  of 
fellowship.  Little  did  Hahnemann  dream  where  this  false  step 
was  to  lead  to;  but  the  moment  the  first  step  was  taken, 
HomcBopathy  was  launched  on  an  ocean  without  a  shore,  and 
such  it  has  proved  to  be. 

On  seeing  in  the  practice  of  others  the  extravagant  lengths 
to  which  the  potentizing  theory  was  being  carried  by  some  of 
his  followers,  Hahnemann,  apparently  for  the  first  time,  saw  the 
danger  to  which  it  was  leading,  and  exclaimed  that  "  the  thing 
must  stop  somewhere."  Stop  somewhere !  how  could  it  ?  The 
boundary  line  of  science  and  experience  had  already  been 
crossed,  and  reason  had  left  the  helm ;  how  then  could  they 
stop  ?  Error,  like  moral  evil,  never  stands  stilL  Being  misled 
by  a  wild  phantom,  the  very  words  of  him  whom  they  called 
master  were  imheeded ;  from  one  potency  they  went  to  another, 
each  new  stage  of  extravagance  but  preparing  them  for  a  higher 
and  higher  flight,  nearer  and  nearer  to  the  regions  of  fairyland. 
Is  this  developing  medicine  as  a  science  or  as  a  caricature  ? 
Is  this  the  way  that  Homoeopathy  is  to  be  raised  in  the  esti- 
mation of  intelligent  and  scientific  men  ?  Is  it  thus  we  ex- 
pect to  conquer  the  world  ?  Verily,  no ;  it  is  thus  that  dis- 
cord and  disunion  have  been  sown  in  our  ranks,  our  influence 
in  the  world  enfeebled,  and  the  day  of  our  final  triumph  post- 
poned. Let  us  unite  on  a  rational  and  scientific  basis :  thus 
united.  Homoeopathy  shall  move  the  world ;  opposition  shall 
quail  before  its  presence ;  for  it  shall  then  manifest  to  the  public 
and  the  profession,  not  only  the  name,  but  the  power,  of  the 
true  science  and  art  of  healing. 

VOL.  ni.  1 


18  Is  the  Doctrine  of  InfinitemnaU 

VI. — The  Doctrine  of  Infinitesimals  is  Unscientific — 

1st.  Because  incomprehensible. 

The  use  of  infinitesimals  is  destructive  to  all  scientific  pre- 
cision in  practice.  One  of  the  essential  elements  in  every 
science,  and  without  which  it  cannot  be  called  a  science  at  all, 
is,  that  in  performing  any  operation  or  experiment,  both  the 
quantity  and  the  nature  of  the  materials  are  really  understood. 
Infinitesimal  potencies  are  not  imderstood.  All  potencies 
above  the  1 2th  are  beyond  the  pale  of  calculation  in  so  far  as 
mental  conception  is  concerned.  Whether  we  look  upon  the 
potency  as  the  representative  of  a  disembodied  force  or  of  finely 
divided  atoms,  the  mind  has  no  power  of  dealing  with  them ; 
it  is  the  process  alone  which  is  underatood,  and  it  is  the  intel- 
ligibility of  the  process  that  has  misled  both  the  practitioner 
and  the  public.  These  potencies  are  spoken  about,  written 
about,  and  used  in  such  a  familiar  way  as  if  we  knew  tho- 
roughly what  we  were  speaking  about  and  using ;  whereas  m 
reality  no  one  knows  anything  about  them,  neither  can  he  form 
any  conception  regarding  them.  As  a  consequence,  where  men 
once  give  themselves  up  to  be  led  by  the  unknown  and  in- 
conceivable in  science,  degrees  of  the  unknown  and  inconceiv- 
able are  all  alike.  The  tongue  can  jump  with  ease  from  the 
6th  to  the  12th,  from  the  30th  to  the  60th,  from  the  100th 
to  the  200th,  from  the  500th  to  the  1000th  potency;  and  it 
is  just  as  easy  to  speak  of  and  understand  the  200th  or  2000th 
as  to  speak  of  and  understand  the  30th  or  12th.  What  do 
these  figures  mean  ?  what  do  they  represent  ?  I  may  be  told 
that  they  represent  a  particular  stage  in  a  process  of  prepara- 
tion to  which  the  drug  has  been  subjected.  Yes,  these  figures 
represent  processes,  and  nothing  more.  The  profession  and  the 
public  imagined  that  they  represented  quantities  of  the  drug, 
but  this  is  not  so. 

I  do  not  for  a  mojient  doubt  but  that  every  Homoeopathist 
who  administers  infinitesimals  holds  that  it  is  not  tlie  degree 


Consistent  with  Reason  and  Experience  /  19 

or  stage  of  process  that  is  anything  in  the  matter,  but  that  it 
is  the  drug,  or  force,  in  the  particukr  fonn  or  condition  repre- 
sented by  the  degree  or  process,  that  is  everything.  This  par- 
ticular condition  or  form  of  drug,  or  force,  however,  being  be- 
yond our  capacities  to  conceive  of  or  apprehend,  cannot  be  the 
subject  of  intelligent  consideration  or  choice.  This  being  the 
case,  one  inconceivable  or  unknown  quantity  may  just  as  well 
be  chosen  as  another ;  but  such  a  choice  can  have  no  claim  to 
logical  or  scientific  precision. 

In  the  practice  of  medicine,  the  mind  perceives  abnonnal 
sensations,  abnormal  functions,  and  abnormal  conditions  of 
structure ;  it  also  perceives  a  more  or  less  striking  resemblance 
between  the  pathogenetic  symptoms  of  the  drug  and  those  of 
the  disease.  In  prescribing  a  remedy,  the  mind  also  perceives 
the  particular  quantity  and  form  in  which  it  is  to  be  used.  In 
choosing  between  different  drugs,  it  is  not  mere  signs  or 
symbols  which  are  before  the  mind — ^it  is  not  a  choice  between 
A.  and  B.,  or  between  B.  and  C,  but  between  certain  definite 
drugs ;  and  so  in  the  same  way  in  regard  to  the  dose.  The 
choice  ought  to  be  made  in  regard  to  a  certain  definite  quan- 
tity of  material,  if  material  is  believed  in ;  or  of  degree  of  force, 
if  the  idea  of  force  is  entertained.  But  to  do  this  there  must 
be  a  conception  in  the  mind  of  the  quantity  or  the  degree,  and 
this  quantity  or  degree  is  then  represented  by  arithmetical 
figures.  It  will  never  do  to  say  that  the  mind  conceives  of 
the  12th  or  the  30th  potencies.  The  30th  potency  simply 
represents  a  stage  in  a  process ;  it  is  the  symbol  of  a  stage  of 
calclilation — it  is  not  the  thing ;  it  is  neither  the  quantity  of 
matter  nor  the  degree  of  force.  The  choice  of  any  particular 
process  is  easy  enough,  but  the  choice  of  any  particular 
degree  ought  to  be  determined  by  the  previous  choice  of 
what  that  degree  represents.  And  as  these  degrees  repre- 
sent what  surpasses  the  powers  of  the  mind  either  to  under- 
stand or  conceive  of,  it  follows  that  we  cannot  make  any  intel- 
ligent choice  of  them  at  aU ;  processes  are  chosen,  not  doses. 


i>\  1$  the  Doctrine  of  Infinitesimals 

ijui    ]\  hi  unscientific,  because  impracticable. 

JjL?..v.VAJ-vjiil  jxitencies  are  picpared  by  the  processes  of 
\r:.\\.*'k:.\..';:j,  &iid  succussion.  The  doctriuc of  potentizing  assumes, 
Ic.  \:j>a  jj^^XUiT  iij  infinitely  divisible;  2nd,  that  in  the  pro- 
o*«>*h;3*  './  trituration  and  succussion  the  particles  of  a  definite 
v:.t.:.;.v.  of  a  drug  undei^o  a  certain  definite  amount  of  sub- 
c,»^l'-v:-:    and  3rd,  that  the  subdivision  has  no  limit — ^it  is 


*- » J*:. 


\'i'>.L7Ut  dij$puting  here  the  doctrine  of  the  infinite  divisi- 
U,Jv.'  of  iriatt^r,  a  question  of  greater  practical  importance 
zrlv:^>i  at  ihfi  outset — namely,  have  we  the  means  by  which 
yrti  cajj  ^Jivide  matter  infinitely?  From  the  nature  of  the 
<iueJ:tion,  I  know  that  no  one  will  say  we  have.  And  if  we 
hnvh  not,  then  to  all  intents  and  purposes  it  is  not  infinitely 
diviisiblr^  Lut  let  us  proceed  to  examine  the  processes.  Firsl^ 
a£  to  triturations. 

To  prrjjiare  the  first  trituration,  1  gr.  of  a  drug  is  triturated 
with  99  grs.  of  sugar  of  milk  for  three  hours;  and  as  all  the 
I^articles  both  of  the  sugar  of  milk  and  drug  are  equally  tritu- 
rate^l,  they  must  also  be  equally  subdivided, — so  that  when  the 
operation  is  completed  we  have  99  times  more  particles  of 
sugar  of  milk  than  we  have  of  drug.  Absolute  perfection  in 
this  j)roce8S  is  impracticable;  but  assuming  that  perfection  were 
attained,  wo  would  have  throughout  the  mass  1  particle  of 
drug  surrounded  by  99  particles  of  sugar  of  milk.  To  prepare 
the  second,  1  gr.  of  the  first  is  added  to  another  99  grs.  of  fresh 
sugar  of  milk.  Now,  observe  that  the  particles  of  the  1  gr.  were 
originally  exactly  of  the  same  size  as  those  of  the  sugar  of 
milk,  and  that  it  required  three  hours'  rubbing  to  bring  them 
to  their  present  condition.  This  mixture,  then,  of  the  1  gr.  of 
the  first  trituration  and  99  of  sugar  of  milk  is  triturated  for 
another  three  hours.  At  the  end  of  this  period  it  is  evident 
that  the  last  99  grains  of  sugar  of  milk  will  be  brought  into 
exactly  the  same  state  of  subdivision  as  the  1  gr.  was ;  and  the 
question  arises,  does  the  1  gr.  which  was  previously  triturated 


Consistent  with  Reason  and  Experience  t  21 

undergo  any  farther  subdivision  ?  If  it  does,  then  we  must 
have  in  the  second  trituration  an  irregular  mixture  of  particles 
of  different  sizes,  which  is  highly  improbabla  Beason  and  prac- 
tical experience  in  the  matter  would  lead  us  to  conclude  that 
aU  the  particles  of  the  second  trituration  are,  when  the  process  is 
carefully  conducted,  exactly  of  the  same  size ;  so  that  the  small 
proportion  of  the  drug  in  the  1  gr.  of  the  first  trituration  under- 
goes no  further  subdivision  of  its  particles  in  No.  2,  and  the  same 
is  the  case  in  No.  3,  the  three  hours'  trituration  merely  serving 
to  bring  up  the  fresh  proportion  of  sugar  of  milk  to  the  same 
condition  of  subdivision  as  the  1  gr.  which  was  added  to  it. 
All  the  particles  in  the  third  trituration  are  of  the  same  size. 
In  No.  1  we  have  99  particles  of  sugar  of  milk  for  every  1  of 
drug;  in  No.  2  we  have  10,000  particles  of  sugar  of  milk  for 
every  -1  of  drug;  in  No.  3  we  have  1,000,000  particles  of 
sugar  of  milk  for  every  1  particle  of  drug.  The  idea  that  the 
drug  is  equally  divided  or  spread  through  the  whole  sugar  of 
milk  is  utterly  impossible,  and  yet  the  triturations  are  spoken 
of  as  if  every  particle  of  sugar  of  nulk  were  impregnated  with 
or  associated  with  a  corresponding  particle  of  drug — a  notion 
contrary  to  reason  and  fact. 

Then,  as  regards  the  succussions,  we  have  the  very  same«con- 
dition.  In  the  first  tincture  we  have  drug  and  spirit  of  wine. 
The  particles  of  the  drug  and  the  particles  of  the  spirit  of  wine 
have  each  a  definite  size ;  and  if  the  tincture  is  a  real  tincture, 
and  not  merely  a  mixture  or  suspension,  we  have  the  particles 
of  the  drug  and  the  particles  of  the  spirit  of  wine  both  of  the 
same  size.  It  is  quite  impossible  to  conceive  of  the  particles 
of  the  drug  in  this  instance  being  smaller  than  those  of  the 
spirit  of  wine.  Making  this  a  starting  point,  then,  we  have  in 
No.  1,  one  drop  of  6  added  to  99  of  spirit  of  wine,  and  well 
shaken  by  10  (some  use  60)  forcible  jerks  of  the  ann. 
What  is  the  result,  and  what  have  we  ?  We  have,  1st,  1  drop 
of  6,  which,  if  you  please,  we  shall  call  drug — one  drop  of 
this  drug,  the  particles  of  which  are  of  a  defimte  size,  and  99 


22  Is  the  Doctrine  of  Injiniteeinials 

drops  of  spirit  of  wine,  the  particles  of  which  are  also  exactly 
the  same  size.  This  being  so,  we  have  99  particles  of  spirit  of 
wine  to  every  1  of  drug  ;  by  shaking  this  for  any  length  of  time 
you  like — 1  minute,  5  minutes,  or  60  minutes — what  occurs? 
The  drug  particles  and  the  spirit  of  wine  particles  both  go 
through  the  same  process;  are  both  subjected  to  the  same 
action ;  the  effect  on  the  one  must  be  the  same  as  that  on  the 
other — there  can  be  no  difference — so  that  at  the  end  of  the 
process,  however  long  continued,  we  have  99  times  more  par- 
ticles of  spirit  of  wine  than  of  drug.  If  it  can  be  supposed 
that  the  particles  of  the  spirit  of  wine  may  be  subdivided  by 
the  shaking,  then  it  may  also  be  supposed  that  the  particles  of 
drug  are  proportionately  subdivided ;  but  though  spirit  of  wine 
were  shaken  till  doomsday  we  have  no  reason  to  believe  that 
its  particles  are  ever  altered  in  size,  and  certain  it  is  that  the 
particles  of  the  drug  cannot  be  subdivided  without  those  of 
the  spirit  of  wine  undergoing  a  similar  change,  which  is  con- 
trary to  all  reason. 

In  No.  2  we  have  1  drop  of  No.  1  mixed  with  another  99  drops 
of  fresh  spirit  of  wine,  and  again  well  shaken,  and  the  change 
which  takes  place  is  the  very  same  as  that  which  took  place  in 
No.  1.  The  particles  of  the  spirit  of  wine  are  of  the  very  same 
size  as  those  of  the  1  drop  of  No.  1,  and  no  amount  of  shaking 
can  ever  alter  them.  The  drug  particles  are  also  of  the  same 
size,  so  that  practically  at  each  new  stage  of  dilution  the  par- 
ticles of  the  original  drug  are  rapidly  getting  fewer  and  fewer ; 
and  as  they  undergo  no  further  subdivision,  they  must,  in  the 
very  nature  of  things,  come  to  an  end  long,  I  believe,  before 
coming  to  the  30th  potency. 

From  all  this,  I  am  bound  to  conclude  that  the  infinite  sub- 
division of  matter  is  impracticable,  and  that  we  have  no  reason 
to  believe  it  can  be  carried  up  to  the  30th  potency. 

3.  Unscientific,  because  imcertain. 

Hahnemann  recommended  the  attenuation  of  drugs  to  be 
stopped   at   the    30th  degree.     Why?     Why  not  carry  the 


Consistent  vnth  Reason  and  Experience  t  23 

process  higher  and  higher,  as  has  been  done  by  some  of  his 
followers,  if  it  is  true  that  the  curative  power  becomes  more 
and  more  developed  the  higher  we  go  ?  Hahnemann  recom- 
mended that  the  process  should  be  stopped  at  the  30th  potency, 
in  order,  he  says,  to  secure  uniformity  in  the  strength  used  by 
different  practitioners  all  over  the  world.  Uniformity !  What 
could  he  mean  ?  Did  he,  or  does  anyone,  imagine  that  two 
different  samples  of  the  30th  potency,  prepared  by  two  different 
individuals,  with  every  amount  of  care  and  nicety,  are  uni- 
form as  regards  the  number  of  drug  particles,  or  the  amount  of 
drug  power,  they  contain  ?  He  must  have  had  strange  notions 
of  uniformity  if  he  did.  Uniformity  in  potencies  is  an  im- 
possibility, for  the  following  reasons  : — 

1st.  On  account  of  the  essential  difference  in  the  propor- 
tion of  drug  force  or  active  drug  power  contained  in  apparently 
the  same  quantity  of  two  different  samples  of  the  same  drug. 

2nd.  Because  of  the  difference  in  the  precise  number  of 
molecules  in  different  samples  apparently  alike.  A  considerable 
number  of  particles  of  a  drug  have  no  effect  whatever  in 
turning  the  balance  in  any  of  the  scales  in  ordinary  use ;  and 
any  difference  at  all  in  the  number  of  molecules  in  the  first 
grain  of  the  drug  must  make  a  great  difference  in  the 
potencies  afterwards.     I  need  not  enlarge  on  these  two  heads. 

Again,  the  first  dilution  of  the  drug  is  made  by  adding  1 
drop  of  the  drug  juice  to  99  drops  of  spirit  of  wine.  Now, 
it  cannot  be  doubted  that  the  one  drop  is  intended  to  represent 
a  definite  and  uniform  quantity — that  it  should  contain  a  defi- 
nite and  uniform  number  of  particles;  but  in  pouring  out 
drops,  I  ask,  is  it  at  all  possible  to  be  sure  that  you  have 
always  a  drop  of  exactly  the  same  size — a  drop  containing 
exactly  the  same  number  of  particles  ?  I  have  been  engaged 
in  weighing  grains  and  measuring  drops  for  nearly  30  years, 
and  I  am  confident  that  no  one  can  approach  anything  near  to 
certainty  in  this  matter.  Some  one  might  be  inclined  to  say  that 
a  little  difference  is  neither  here  nor  there ;  but  a  believer  in 


24  Is  the  Doctrine  of  InfinUmmaU 

potencies  cannot  with  any  propriety  say  that,  although  practi- 
cally, I  liavo  no  doubt,  it  makes  no  diffeTcnee.     The  difference 
in  the  size  of  difTerent  drops  often  amounts  to  a  great  deal — ^I 
believe  frequently  from  the  tenth  to  the  fifth  part  of  the  whole. 
Such  a  difTerence  as  this  is  e([ual  to  the  difference  of  a  con- 
siderable  number   of    potencies — a    difference    reckoned    by 
billions  and  trillions.      From   this  I  am  forced  to  conclude 
that  not  one  of  the  potencies  represents  anything  approaching 
to  a  definite  quantity,  such  as  the  number  it  bears  would  lead 
us  to  expect ;  that  in  most  cases  the  same  potency  nominally 
will  vary  to  a  veiy  great  extent ;  that  out  of  30   samples,  we 
cannot  make  sure  of  having  any  two  of  them  alika     We  may 
have,  in  so  far  as  quantity  in  the  original  drop  is  concerned, 
one  in  reality  representing  the  20  th,  another  the  21st,  another 
the  22nd,  and  so  on  up  to  the  30tL     This  cannot  be  avoided. 
Is  this  the  way  to  secure  uniformity  ?     Can  such  a  practice 
deserve  the  name  of  certainty  or  of  precision.    Then,  in  preparing 
the  triturations,  besides  the  constant  and  unavoidable  difference 
in  the  absolute  quantity  of  the  first  grain  of  the  drug,  there  is  a 
very  considerable  quantity  of  the  material  which  passes  off  during 
the  operation,  and  especially  towards  the  termination.     And 
even  allowing  that  the  one  grain  of  the  first  trituration,  when 
again  triturated  for  three  hours  with  a  second  99  grs.  of  sugar 
of   milk,  should  undergo  a   still   further   subdivision   of  its 
particles,  it  is  clear  that  a  very  considerable  proportion  of  this 
one  grain,  from  the  extreme  fineness  of  its  particles,  will  at 
once  begin  to  escape  from  the  mortar  the  moment  the  mixture 
is  agitated  by  the  pestle,  and  that  this  escape  will  go  on  the 
whole  time  of  the  three  hours'  trituration,  and  thereby  cause  a 
very  considerable  loss.     All  who   are  practically  acquainted 
with  the  use  of  the  pestle  and  mortar  know  this  wclL     No 
doubt,  as  the  trituration  proceeds,  the  escape  takes  place  from 
the  whole  mass,  including  both  sugar  of  Tm'lTr  and  drug ;  but  at 
first,  and  during  the  earlier  part  of  the  process,  the  chief  loss, 
comparatively  speaking,  must  be  from  the  one  grain  of  the  first 


Consistent  with  Reason  and  Experience  t  25 

trituration;  and  a  loss  of  this  kind,  to  any  extent  at  all,  mnst 
tell  to  a  vast  extent  on  the  succeeding  potencies. 

VII. — ^The  Docteine  op  Infinitesimals  Opposed  to  and  Sub- 

VEBSIVE  OF  HOM(EOPATHY. 

Homoeopathy  may  be  defined  to  be  the  curing  of  a  disease 
by  a  drug  which  has  the  power  of  producing  in  the  healthy 
body  an  artificial  disease  similar  to  the  one  under  which 
the  patient  suffers. 

In  this  definition,  three  elements  are  introduced : — 

1st.  A  knowledge  of  the  symptoms  of  the  drug  disease. 

2nd.  A  knowledge  of  the  symptoms  of  the  natural  disease. 

3rd.  The  administering  of  that  very  drug  which  produced 
the  artificial  disease,  the  similarity  of  which  to  the  natural 
disease  was  the  ground  of  its  choice. 

The  theory  and  use  of  infinitesimals  is  opposed  to  this  last 
essential  element.  Let  us  see  how  this  is  so.  In  all  fedmess, 
this  last  element  involves  but  one  meaning — ^namely,  that  not 
only  must  the  drug  used  be  the  same  in  name  as  that  which 
produced  the  artificial  drug  disease,  but  it  must  also  be 
identical  with  it  in  regard  to  the  nature  of  its  mode  of  action : 
the  nature  of  the  force  it  exerts  must  be  the  same.  It  may 
differ  in  its  form,  in  its  quantity ;  but  it  must  not  be  in  any 
sense,  or  in  any  essential  respect,  different  from  the  drug 
proved.  It  must  not  only  have  the  same  original  force  which 
the  drug  proved  had,  but  it  must  possess  no  new  power  which 
the  original  drug  did  not  possess ;  neither  must  it  possess  any 
powers,  newly  developed  in  it  by  any  process  or  processes  to 
which  it  may  have  been  subjected,  which  were  not  in  active 
operation  in  the  original  drug,  and  by  virtue  of  which  it 
produced  its  artificial  drug  disease.  All  this  is  abundantly 
clear,  and  all  this  is  distinctly  contradicted  by  the  theory  of 
infinitesimals. 

The  doctrine  of  potentization  and  dynamization  implies  that 
drugs    possess  a  deep-seated  latent  power  which  cannot  be 


:.  '••  s-'^Lririot  .  but  T*  ^  ^2js 


ii.  :  !.-.  '.':.«!  '  :.  .  *  v  ^".■.  .-  fi.:.  .:'-]  -.\: lai^t.-ri-  tLr-.rle* 
li:!\»-  fp*.:!  ;.:.-■..:-  ■'    i  :'..•:•  •-:-:lzi::j  f-}^:-:::.     Sr-n-r 

l^li-Vi-  :]i:.*.  t:..-  1.:-:.:  ;•  ••'■•:  :-  r-i-r/.y  >  v->.ji*-lly  the  lonj- 
«:«jijiiii?M-il  j.jr.i-f.*^..^  •.,  v;.,  ?.  !:.*,-  ir:.'*  fire  su'^-jt-.ted  :  oti^rs 
JMiiiviii"  tii;il  !;.•■:..•  .-  -  :..-■  •  '.-  tr:  .1  i..:-J  *A  ]».'W»'r  Jf vek'jied  or 
)^roii;.'ljl  into  act  i'.iij  'J;!i:.j  ::.-  :;::  .'-tliii'  j  r  ":>-55  :  and  others 
\A'.\\ii\i',  i]iut  tin.*  nattJiL.!  u;a:--.:-r  of  tL'j  Jruj!  is  entu^elT 
silt<.-j<"J  in  tli«  cuujvi  of  j.ot'.-ijiiziii;:,  Liid  that  the  so-called 
*Ji»j;?  jjiatcml  W;oiiJC'S  i:jj]'j'.-L'ijat».-l  Ly  a  liiaguetic  pcwer 
'•lij'rlly  <l(.-jived  1j-<^iji  the  j^'.-i-soii  of  tlif:  j^oteiitizer.  All  these 
tii«o]j.:ft  ani  on  a  par;  and  whi'.h'.-vtr  is  held  to  he  true,  it 
JiijiJy    roiilj-adicts    t]je    cliiof  ajid    most    essential  element    of 

'iii«:  j/i<iat  majority  of  Iloma-opathists  believe  that  the 
|/i'i'<.-a  i,f  trituration  and  succussion  operates  simply  by 
Wjwdijij/  tiji'  jiartides  of  the  dru;;,  so  as  to  make  their  solution 
"^ii'l^i- 1,:  iuid  t)ionMj;,di.  TJjiH  I  l>eli*;v(i  is  all  that  is  accomplished 
*'  'ill  tijiii.  u  r«'quinnl.  lint  a  bidiciver  in  potencies  may  also 
•"■  iii-  iiJi.d  Ui  say  that  thci  newly-(h;v«doped  power  is  of  the 
-'ii»«.  ijjitiji,..^  u,j,i  dejMindrt  upon  th«j  samd  original  i^ower  which 

*'""' ^  '*"■■  '*'■'*«  «y*iJptoiim.      Tni(!,  tlic'ir  origin  may  be  the 

"■     ■'    ■>^'«ill«il^i  4;irrrtivi'.   powi'i-H  th(»y  arc  entirely  dif- 

I     '•    i.a  hi.-lii  i)„jt   liny    nciw    power  whatever   is 

»."•>•  Jiij/j,jj^  i>*'"'«'Marrt,  thnn  my  argument,  that 

"'''■"'  ■'*  *''  *'*»'  «|'iiit  of  llomdiopathy,  holds 

'•*"*' V   •'■>'.h..u  Ihut  //i,.    ,M,wiT   in  the  drug 

^  .  '  '  Z'   '^'"'■"•"^  "*•  •'»"  iH'althy  l)ody  is  ^A« 

^'V  »/'/^*^.*.  whJMh    IU-I.M  rumtively  on 

//  "'     *'  ''"'''"'■'■'♦  •'»•««  «)iMptoni8  in  the 

^"    '  ^  nnrnn,    *Mi  M^  .„r,aivoly  in 


Consistent  with  Reason  and  Experience  1  27 

the  diseased  body,  then  the  Homoeopathic  principle  is  sub- 
verted. 

If  words  have  a  meaning,  there  can  be  no  doubt  that  the 
new  curative  power  said  to  be  developed  by  the  processes  of 
trituration  and  succussion,  though  naturally  inherent  in  the 
drug,  was  in  a  latent  and  inoperative  condition,  and  could  be 
called  into  active  operation  only  by  the  potentizing  processes. 
But  the  fact  that  the  drug  in  its  natural  condition  manifests 
in  the  healthy  body  its  characteristic  disease-producing  power, 
proves  that  this  its  disease-producing  power  was  not  in  a  latent 
condition,  but  operative ;  and  that,  therefore,  the  latent  power 
developed  by  the  potentizing  process  cannot  be  this  disease- 
producing  power  of  the  drug,  but  some  other  power.  I  am 
therefore  justified  in  concluding  that  the  new  curative  power 
developed  by  the  potentizing  process  is  different  from  the 
disease-producing  power  of  the  drug,  which  is  subversive  of 
Homoeopathy. 

But  if  the  potentizing  processes  do  not  develope  any  new 
power,  what  becomes  of  the  potentizing  theory  ?  If  the  mul- 
tifarious and  minute  processes  recommended  by  Hahnemann, 
with  the  sole  and  avowed  purpose  of  developing  a  new  power 
formerly  latent  in  the  drug,  fail  in  developing  any  such  new 
power,  then  the  entire  theory  and  processes  of  potentization 
becomes  a  failure. 

If  the  potentizing  theory  is  given  up,  then  the  potentizing 
processes  ought  to  be  abandoned ;  for  these  processes  were  not 
introduced  by  Hahnemann  merely  to  subdivide  the  drug,  but 
in  order  to  develope  the  new,  often  prodigious  and  over- 
whelming power  of  the  drug.  Thorough  subdivision  of  our 
drugs  is  aU  we  require,  and  no  mysterious  potentizings.  The 
disease-producing  power  of  the  drug,  which  it  manifests  in  its 
ordinary  subdivided  condition,  is  the  alone  power  which 
cures  disease.  The-^evelopment  of  latent  powers  is  a  fabri- 
cation. 

Potentizers,  to  be  consistent,  ought  to  institute  a  new  aecu» 


28  Is  the  Doctrine  of  I^/initerinuU$ 

of  provings  with  potentized  drugs,  and  be  guided  in  their 
choice  of  a  remedy  by  such  provings ;  but  until  this  is  done, 
I  hold  that  their  present  practice  of  being  guided  in  the 
selection  of  a  remedy  nominally  by  provings  obtained  by  the  use 
of  drugs  whose  inner  or  inmost  drug  power  was  latent  and  in- 
operative, and  then  applying  the  drug  with  this  its  inmost 
power  prodigiously  developed,  is  opposed  to  one  of  the  cardinal 
elements  of  Homoeopathy. 

VIII. — ^The  Doctrine  of  Infinitesimals  involves  ak 
Absurdity. 

The  theory  of  potentizing  and  spiritualizing  assumes  that 
the  spiritual  force  of  the  drug  is  not  only  developed  in  the 
processes  of  trituration  and  succussion,  but  that  it  is  set  firee 
from  its  material  embodiment.  It  is  amusing  to  see  how 
fanciful  statements  of  this  kind  have  been  accepted  and 
credited  by  men  of  intelligence,  apparently  without  the  slightest 
question.  Granting,  for  the  sake  of  argument,  that  the  drug 
force  is  &eed  £rom  its  material  embodiment,  in  what  form,  I 
would  ask,  does  it  exist  in  the  sugar  of  milk  ?  Is  it  mixed 
with  the  latter ;  or  how  is  it  ?  Have  we  any  example  of  forces 
mixing ;  and  what  are  they  ?  Is  it  not  an  established  fact  that 
forces  never  mix,  but  that  they  always  combine  i  Is  it  sup- 
posed that  the  spiritual  force  formerly  resident  in  the  drug 
combines  with  the  sugar  of  milk,  or  that  it  combines  with  the 
sugar  of  milk  force  ?  If  so,  what  reason  have  we  to  believe 
that  this  new  combination  will  manifest  the  same  character  as 
the  drug  ?  And  supposing  it  has  the  same  character — ^what  is 
gained?  The  spiritual  force  residing  in  the  new  compound 
will  require  to  leave  that  embodiment  before  it  acts  on  the 
organism,  just  in  the  same  way  as  it  would  require  to  separate 
from  its  natural  embodiment — ^the  drug. 

In  the  liquid  spiritualization,  in  what  form  have  we  the 
drug  force  ?  Is  it  simply  mixed  up  with  the  spirit  of  wine ; 
or  how  ?     Have  we  any  example  of  a  force  being  shaken  up 


Consistent  with  Reason  and  Experience  t  29 

and  mixed  with  water  or  spirit  of  wine  ?  Does  the  drug  force 
combine  with  the  spirit  of  wine ;  and,  if  so,  what  is  the  nature 
of  the  new  compound  ?  Is  it  drug— or  what  ?  And  if  a  new 
compound,  what  becomes  of  the  spiritualizing  theory  ? 

We  can  act  on  matter,  whether  in  the  solid  or  liquid  state, 
and  divide  or  mix  it  at  pleasure ;  but  forces  cannot  be  rubbed 
in  a  mortar,  or  shaken  in  a  bottla  Forces  can  be  evolved 
only  by  decomposition;  and  decomposition  can  only  take  place 
by  the  component  parts  of  the  substance  entering  into  new 
forms  of  arrangement — ^new  combinations.  Look  at  this  sub- 
ject of  potentization  in  any  way  you  like,  it  certainly  does 
appear  ridiculous — nay,  it  is  even  absurd ;  for  just  see.  Is 
it  not  an  extraordinary  idea,  to  talk  about  rubbing  a  force  out 
of  matter  ?  Is  it  not  equally  extraordinary  to  talk  about  rubbing 
a  force  into  matter  ?  But,  even  supposing  that  the  drug  force 
is  rubbed  out  of  the  drug  into  the  sugar  of  milk,  must  it  not 
follow  that  the  same  rubbing  which  rubbed  the  force  out  of 
the  drug  material,  will  also  rub  the  force  out  of  the  sugar  of 
milk  ?  If  the  force,  then,  is  rubbed  out  of  the  drug,  and  also 
nibbed  out  of  the  sugar  of  milk,  and  consequently  is  neither  in 
the  one  nor  the  other,  wiU  any  potentizer  teU  me  where  it  is  ? 

This  lengthened  and,  I  am  afraid,  in  some  respects  tedious 
paper  is  now  finished.  I  fully  expect  that  where  such  a  variety 
of  material  has  been  introduced,  and  that  of  a  somewhat  diffi- 
cult character,  deficiencies  and  errors  must  have  crept  in.  I 
shall  now  be  glad  to  see  these  pointed  out  and  corrected. 

DISCUSSIONS. 

Dr.  Hale,  while  thanking  Dr.  Cockbum  for  his  paper,  which 
gave  the  Society  an  opportunity  of  that  full  and  free  discussion 
which  the  subject  demanded,  differed  in  toto  from  the  conclu- 
sions arrived  at  by  Dr.  Cockbum.  Dr.  Hale  believed  that  Dr. 
Cockbum's  premises  were  false  and  faulty,  and  that  therefore 
his  conclusions  were  also  false  and  faulty.  In  the  first  place, 
Dr.  Cockbum  had  tried  to  prove  the  analogy  between  food  and 
dmgs — ^an  analogy  which  Dr.  Hale  entirely  denied.    Dr.  Hal^ 


30  /<  th»'  Dol/'iM  of  I  Hji  nit'. si  mats 

*..'.i'.  :•  :■  •!  tii;it  frx*<l  was  pn-ii-nti*!  to  the  system  in  material 
'j  I  :.'.•.•.. -■,  }m/;iii.-.-,  fptiii  til.*  v«ry  iijitiire  of  its  uses,  it  was 
Ur: '.'i  \ii*n  t}j*r  Tsv-ti'iii  in  orl«T  tn  Iwf  assiiiiilatftl  and  deposited 
Hi  ;.'..i'»  .'i;i!  ^j»i;tiititii-i  fur  thf  ;,T'»^»tli  and  dt-wloimient  of  the 
\,-,'\  /  N'lt  -o,  )iowiv»r,  w»-p'  drug's,  which  are  taken  into  the 
\.  '-  ::.  ii'ft  for  ^Towth  and  (l«'V«-liiiniMnt,  hut  ft»r  the  purpose  of 
\,:'>  .'..ir/  'Jvnariii':  ''han;j«-s  in  th»j  or;;ani»Ltinn  when  disea5e<l 
o'  'I.  /i."! -p-'l.  Tht'.  ari^iiiiHiit  fnr  th»-  n«*ct'?ssity  of  material  doses, 
?/;i  ■• :  jj/ori  an  anaIo;.'y  which  did  nut  «*xist,  was  therefore  op- 
{,',  -  i  to  -t'lt^uct:  and  jiliihi.'Oiihy.  Dr.  Ilsde,  secondly,  entirely 
':■■  '  ;jN-'i  from  I)r.  ^'ockhiirn's  s*tut<*nn*nt,  tliat  the  necessities  of 
'/::'.:r.i/;iti«iri  n;'jiiind  tliat  drii^js  shoiilil  not  l)e  exhibited  in  in- 
f*:..*i  '.mill  'lovrH.  Dr.  Halt*  inaintaimnl  that  all  modem  discovery 
hv  T;,':  iiijcroHfoi*fi,  11h;  niiniitii  anatomy  of  the  hmnan  body,  the 
f;i//  .  of  c#:II  rh;v*rlopnir;nt  and  c^ill  pathologj',  jKjinted  the  other 
v/ay,  nu'\  rl^rarly  \trhVi'A  that  if  dnigs  arc  intended  to  reach  the 
/jjjijiiV:  ilriictiire  of  any  rlisoased  oryan,  they  must  be  brought  to 
?:u':li  a  ;-.taU;  of  luinutc  sulxlivision  as  will  enable  them  to  per- 
iii*:itU:  and  iutt  u])Ou  tluj  microscopically  minute  structures  com- 
j/o-.iii:'  tlif!  vttrir>ns  or;;aiis.  Dr.  Hale  consideretl  the  physical 
tit'.':t::Mif*/A  of  our  or;(anization  one  of  the  strongest  arguments 
in  favour  of  infinite jsinial  doses.  Dr.  Cockburn  had  introduced 
an  ai;MUMr;nt  a^^ainst  tlitj  u«e  of  infinitesimals,  from  the  uncer- 
tainty u\ii\  unsatJHfactoriiHJHs of  so-called  medicinal  aggravations; 
\fUi  ])r.  Mal<%  wliiKj  aj^rf*(iing  with  Dr.  Cockburn  that  there  are 
HjflirjiHiiH  atUinding  tlu?  V(!rifying  of  aggi'avations,  owing  to  the 
important  jiart  wliich  ofjrtiain  ])hy.siological  conditions  play  in  the 
I;li<'noni<rna  of  <liw-a.se;  yet,  while  he  blieved  that  aggravations 
wtr*'.  not  ivi  i'rc<iw,ui  as  some  would  wish  us  to  believe,  he  had 
iii'Vt'i-i^H'UHH  fn'<jU(^ntly  obsen-ed  them  occurring  from  infini- 
t'rMJnjaldoM^jn,  anrl  had  obs(Tved  them  occurring, moreover,  during 
lii;{  i'uvly  <-xp(  riinrjnts  of  Ilonimopathy,  when  the  patients  were 
not  at  that  iinir;  awarcj  that  they  were  taking  homoeopathic 
rt-iwAu-.i  thuH  HO  far  eliminating  both  in  the  patients  and  in 
hirn:'.'-.lf  i\u\  mental  cause  of  aggravations.  Dr.  Cockburn 
donl»l,<'<l  tho  alIcg(Ml  Ijwits  of  medicinal  aggravation  from  the 
jK'tiori  <i\'  ip<*dw;uanlia  when  inhaled  in  infiuitesimally  minute 
(liiruMion  in  the  air;  but  Dr.  Ilale  would  not  occupy  the  time  of 
thn  Society  \ty  (aichjavouring  to  prove  that  the  accumulated 
weight  of  evidence  in  i)roor  of  such  an  action  of  ipecacuanha 
in  i'AwUiwi  i(IioHyneraci(jH  was  overwhelming,  but  instanced  a  case 
the  Hubjeel  of  whi(jh  was  a  hard-headed  allopathic  sceptic,  in 
whom  the  minutc^st  (piantity  of  white  of  egg  (which  contains 
Hulffhur)  in(hic(Hl  an  attack  of  acute  eczema  whenever  he  partook 
of  food  (jontaining  eggs  in  any  shape.  In  Dr.  Cockbum's  paper 
doubts  vfiwv.  (^xprejssod  as  to  the  action  of  infinitesimals  in  the 


Consistent  with  Reason  and  Experience  ?  31 

treatment  of  syphilis ;  "but  Dr.  Hale  had  succeeded  in  curing 
primary  Hunterian  chancre  with  Merc.  viv.  6th  cent.,  and 
secondary  syphilitic  ulceration  of  the  throat  with  Lachesis  5th 
and  6th  centesimal.  Dr.  Cockbum's  paper  had  an  apparent 
semblance  of  logical  accuracy  in  treating  the  subject ;  but  Dr. 
Hale  considered  his  logic  only  apparent,  and  his  deductions  both 
illogical  and  unsound — for  instance,  one  of  the  arguments  dwelt 
upon  at  some  length  by  Dr.  Cockbum  was,  that  the  administra- 
tion of  infinitesimals  was  unscientific  because  their  modus  ope- 
randi was  incomprehensible.  Dr.  Hale  said  if  this  were  true 
there  would  be  an  end  of  the  practice  of  medicine  :  if  we  were 
to  wait,  before  giving  any  medicine,  until  we  knew  exactly  its 
modus  operandi,  there  would  be  an  end  to  all  progress,  and 
medicine  would  be  an  impossible  art.  As  well  might  the  astro- 
nomer refuse  to  calculate  the  motions  of  the  planets,  or  to  accept 
and  use  the  laws  of  gravity  until  he  had  first  discovered  the 
actual  constitution  of  the  sun.  What  allopath  can  tell  exactly 
the  modus  operandi  of  five  grains  of  blue  pill?  Dr.  Hale 
could  not  follow  Dr.  Cockbum's  argument  as  to  how  a  grain  of 
any  substance,  with  other  grains  of  sugar  of  milk,  conduct 
themselves  when  saturated  in  Dr.  Cockbum's  mortar;  but  in 
order  to  prove  that  matter  was  rendered  visible  to  the  senses  up 
to  the  fifth  dilution,  he  instanced  some  experiments  in  spectrum 
analysis  made  by  him  in  the  presence  of  the  Secretary,  at  a  /.JV 
former  meeting,  in  which  Nitrate  of  Strontia  and  CarhoTUjUe  of 
Barytes  were  rendered  perfectly  sensible  to  sight  in  the  5th  cent, 
dilution.  A  theory  of  Homoeopathy  had  been  propounded  in  the 
paper  just  read,  but  Dr.  Hale  was  not  prepared  to  accept  the 
theory  of  Homoeopathy  upon  which  Dr.  Cockbum  based  his 
argument.  He  was  not  prepared  to  receive  even  Hahnemann's 
theory  of  Homoeopathy.  When  Hahnemann  accumulated  facts, 
and  from  the  induction  by  facts  enunciated  a  laWy  he  was  strong ; 
when  he  theorised,  he  was  weak.  Dr.  Hale  did  not  think  we 
had  yet  a  satisfactory  theory  of  Homoeopathy.  Our  duty  now 
is  to  observe  phenomena,  and  build  up  Homoeopathy  by  facts. 
This  led  him  to  the  very  climax  of  Dr.  Cockbum's  argimient — 
namely,  that  experience  was  against  the  use  of  infinitesimals. 
If  so,  Dr.  Hale  contended,  they  are  indeed  a  delusion  and  a  snare, 
and  thousands  of  homoeopathic  practitioners,  and  tens  of  thousands 
of  patients,  have  been  for  many  years  dreaming  a  fantastic  dream. 
If  this  be  so,  how  comes  it  that  most  of  the  early  trials,  some 
years  ago,  of  the  Homoeopathists  of  any  standing  were  made 
with  infinitesimal  doses,  with  attenuations  from  the  6th  to  the 
30th,  in  globules  ?  Were  our  convictions  of  their  worth  then  a 
"  delusion  and  a  snare  ?"  For  the  first  year  of  Dr.  Hale's  own 
trials  of  Homoeopathy,  he  used  little  else  but  globules  from.  \,W 


32  Is  the  Doctrim  of  InfinUesimaU 

6th  to  the  30th ;  but  is  it  a  dchision  ?  Is  the  Society  prepared 
to  acco])t  Dr.  Cockbum's  conclusions  ?  or  does  the  accumulated 
weight  of  evidence  prove  it  othcm^'ise,  and  prove  it  beyond 
doubt  and  from  experience  to  be  otherwise,  than  Dr.  Cockbnm 
would  liavc  us  to  believe  ?  Dr.  Hale  appealed  to  the  experience 
of  every  member  present  to  substantiate  his  conviction  as  to  the 
power  and  value  of  infinitesimals.  In  conclusion,  Dr.  Hale  said : 
it  is  now-a-days  sometimes  stated  that  Homceopathy  fails  as  it 
used  not  to  fail  If  this  be  so— and  Dr.  Hale  was  not  prepared  to 
allow  that  statement  to  be  true  ; — he  thought  that  if  in  any 
cases  it  were  true,  the  explanation  is,  that  we  had  departed  from 
the  teachings  of  Hahnemann ;  that  instead  of  building  on  the 
sure  foundation  he  laid,  we  allowed  ourselves  to  become  routinists, 
or  associated  certain  properties  to  certain  drugs,  and  prescribed 
them  from  some  fanci^  relationship  to  certain  organs,  and  forgot 
or  neglected  to  obey  the  law  of  homoeopathy.  The  failures  must 
be  laid  to  the  charge  of  the  practitioner,  and  not  to  Homoeo- 
pathy. 

Dr.  Metcalfe  did  not  purpose  entering  upon  the  general  sub- 
ject so  ably  set  forth  by  Dr.  Cockbum.  He  wished  only  to 
speak  in  reference  to  one  or  two  matters  that  had  been  dwelt 
upon.  In  the  first  place,  he  was  surprised  to  find  Dr.  Cockbum 
throwing  doubt  upon  the  fact  of  ipecacuanha  producing  asth- 
matic sufferings.  He  knew  an  instance  in  point.  The  gentleman 
with  whom  he  was  a  pupil  was  thus  aflfected.  So  sensitive  was 
he  to  the  smallest  particle  of  this  drug  that  it  was  necessary  to 
inform  him  if  the  stopper  of  the  bottle  was  removed.  He  never 
could  remain  in  the  surgery  during  the  use  of  it  The  mere 
weighing  out  of  a  grain  never  escaped  his  notica  He  could 
even  tell  if  it  had  been  used,  should  he  within  a  short  period  pass 
through  the  room ;  and  he  well  remembered  on  one  occasion, 
during  the  trituration  of  it,  that  he,  sitting  in  an  adjoining  room, 
rushed  out  calling,  out  "  You  are  using  ipecacuanha ! "  Attacks  of 
sneezing,  and  a  sensation  of  asthmatic  constriction  of  the  chest, 
used  to  be  produced  by  it.  As  to  the  question  of  the  use  of  high 
potencies  of  the  medicines,  he  was  of  opinion  that  their  efficacy 
could  not  be  doubted.  Indeed,  there  were  certain  medicines 
inert  in  their  crude  state,  which  in  the  12th  or  higher  potencies 
I>roduced  marked  effects.  He  had  seen  the  value  of  them  in 
tlio  n;moval  of  small  encysted  tumours  of  the  eyelids,  and 
Hubcutancous  tumours  on  the  scalp. 

Dr.  KiDD :  I  greatly  admire  the  method  Dr.  Cockbum  has 
purHued  in  his  ingenious  and  able  paper.  He  started  from  the 
tru(}  point.  He  began  with  the  history  of  Hahnemann.  In  the 
first  part  of  his  career,  Hahnemann  appears  truly  grand  and 
noble.    Then,  following  pure  observation  and  true  induction,  he 


Consistent  with  Reason  and  Experience  t  33 

discovered  the  grandest  law  of  nature,  Similia  simUibus  eurantur. 
Let  us  recollect  that  for  nine  years  he  practised  with  minute 
doses — not  with  infinitesimal  During  those  nine  years,  in  fact, 
he  founded  the  Homoeopathic  system.  All  his  teaching  afterwards 
was  fanciful,  and  open  to  uncertainty  and  doubt,  like  the  suc- 
cessive theories  of  physicians  through  thirty  centuries.  Hahne- 
mann's nature  was  not  able  to  resist  retaliation.  He  was  fiercely 
attacked,  and  he  imwisely  retaliated.  When  retaliation  comes 
into  play,  truth  goes  out.  This  was  Hahnemann's  error.  Out  of 
contradiction  and  angry  retaliation,  he  plunged  into  the  doctrine 
of  infinitesimals,  founded  on  imagination,  not  on  induction.  This 
practice  of  giving  medicines  in  quantities,  so  unnecessarily  in- 
finitesimal, is  the  bugbear  that  deters  the  majority  of  medical 
men  from  joining  our  ranks.  For  my  part.  Upwards  of  ten  years 
ago  I  separated  the  truth  of  the  homoeopathic  law  from  the  un- 
certain hypothesis  of  infinitesimal  doses,  and  my  success  in  the 
cure  of  disease  increased  tenfold  as  I  followed  the  natural  law  of 
cure,  Similia  similihis  eurantur,  imtrammelled  by  the  fanciful 
theories  of  dynamization.  As  far  as  Hahnemann  followed  truth 
I  follow  Hahnemann,  but  no  farther.  I  applied  the  same  rule  to 
him  as  to  Hippocrates  and  Harvey.  I  would  follow  all  that  is 
true  in  the  teaching  of  these  great  men,  but  I  would  not  foUow 
their  blunders,  nor  feel  bound  to  reverence  their  mistakes.  It  is 
not  for  us  who  have  cast  down  the  ancient  idols  of  medical  wor- 
ship. Authority  and  Theory — ^who  have  renounced  allegiance  to 
fanciful  hypotheses,  to  set  up  this  poor  modem  idol  of  Dynami- 
zation, and  to  fall  down  and  worship  Globulism.  Along  with 
much  truth,  Hahnemann  evolved  much  error.  The  theory  of  in- 
finitesimal doses  is  a  mere  fanciful  hypothesis,  open  to  numerous  ob- 
jections. That  error,  I  for  my  part  have  disowned,  and  do  disclaim. 
The  truth  of  the  law,  Similia  similUms  eurantur,  I  firmly  believe 
in,  as  based  on  induction  from  the  truest  observation  of  facts  and 
value  as  the  most  faithful  guide  in  the  treatment  of  disease. 
But  I  refuse  to  follow  Hahnemann  into  the  region  of  fanciful 
hypothesis.  I  am  a  Homoeopathist  in  principle — not  a  Hahne- 
mannist,  nor  a  Globulist.  Science  tells  us  that  there  are  limits 
to  the  division  of  the  metallic  medicines.  Dr.  Hale  says  he  de- 
tected the  presence  of  mineral  medicine  by  the  spectrum  analysis 
at  the  5th  dilution.  If  the  spectrum  cannot  detect  its  presence 
beyond  the  5th  dilution,  why  attempt  to  fancy  the  presence  of 
medicine  when  even  the  spectrum  cannot  detect  it  ?  Surely  the 
state  of  division  that  the  spectrum  alone  can  detect  is  fine 
enough  for  all  practical  purposes,  and  it  is  but  fair  to  ask  Dr. 
Hale,  why  do  you  not  rest  satisfied  with  the  utmost  limits  that 
the  spectrum  analysis  can  detect  ?  Why  give  the  6th  or  12th 
dilution,  when  we  know  that  there  is  an  exquisitely  diviH 
VOL.  m,  ^ 


?,  i  Is  iht  Doctrine  of  Infinitesimals 

?if. ::.''•* :..:.u.  in  tlir:  5th,  and  there  xnay  be  nothing  in  the  12th 
fi.,  .v^ri '  IM  iifl  follow  truth  for  its  own  sake  and  conmioii 
»>  r.-'v .  ;:r.  I  uf»i  F^e  UA  into  aliHunliticB  out  of  deferenoe  to  Hahne- 
rr.;irt.'.V;  inuf/wH,  I  api^^l  frr>m  Hahnemann  fanciful,  theoretical, 
st.r».\  '.:  /t/.h'ft.y,  to  Hahnemann  vigoroiLS  and  practical,  in  his 
l»T,r:.f',  'A'\(*x(i  v«;xatioiiH  o{i|K)sition  caused  hiiu  to  retaliate. 

\y:.  \)V.v\ci  ff:lt  that  our  thanks  were  certainly  due  to  Dr. 
(^x.K',.:u  for  t.hi;  2i:al  he  Iiad  shown  in  coming  such  a  long 
r:,..Sir.r/:  If,  uMv\  hi.H  jififx^r  Init having  said  that  much,  he  regretted 
V,h\  r.':  *j»\\\t\  KLy  notliing  further  in  tlic  way  of  praise,  as  he 
'!;f^%'<'i  fr^o  alinoHt  f;v<;ry  word  he  luul  heard.  He  had  unfor- 
iuu'A.U'\-f  \^'j.i\  cjiiWt'A  fiway  curly  in  the  evening,  and  so  missed 
tr>/;  Un.t  fi^irt ;  but  from  wliat  lie  heaixl,  it  appeared  to  him  that 
u»f'.  f/i,v:f  'a;ih  all  f4iii,*i;ulation,  which  was  entirely  outweighed  by 
f,rif;  ■■'.itiuM''  'Arf:ilw:.'4taljIi.H)icMl  fuct,  of  wliicli  there  were  numbers  to 
r^'i•i^/:  hr.  ^Vy^khimi.  The  first  jxjint  to  which  he  would  allude 
wa>(,  th^;  iiovf:l  viows  stirted  by  the  author  on  the  divisibility  of 
ifthr/s.  Uf,  thought  it  was  conceded  that  there  was  no  limit 
on  t.hiy.  \i(:nf\ ;  li/iw^jvftr,  if  Dr.  Cockbum  would  produce  the  atom 
alr//Jif.  v/},jf;h  thfjy  rlifff-rerl,  he  (Dr.  Drury)  would  be  very  happy 
t//  '  >ifiiit  iha  tWWiroAiai"  for  him.  The  author  was  puzzled  to 
nnfUir-'.Unfl  th^;  |K;ft8ibility  of  bodies  becoming  incorporated  by 
any  pn  /Hi^:al  a/;tion  ;  yet  such  tilings  did  occur.  In  the  arts — 
rKtfUir  i/,wf'.rf\il  j/ressure — metals  could  be  very  intimately 
\Af-jAf'/\  by  cli^jmical  a/^tion ;  new  compounds  were  formed ;  and 
(;\oO.(.f.,ly  j/rMliic^j/l  vr;ry  wonderful  changes,  which  were  every 
fUiy  c-Ac.Uu^^  our  fuHtonlHliriient  That  trituration  did  develope 
ut.'w  [/'/W'-.fH  in  dni^.H,  Wumh  was  not  a  shadow  of  doubt;  even  on 
a  th\i<f\i  -/;ai<j  Uii.H  powfjrwjis  demonstrated.  Savory  &  Moore,  the 
tUfjm-'XH,  of  h}w\-HiT(i(ii,  were  celebrated  for  their  seidlitz  pow- 
(if-SH.  Now,  thougli  they  used  the  same  ingi'edients  as  other 
tb^;rrji.Ht?j,  yet  their  morle  of  operating  produced  a  much  better 
artjcifj.  Tbey  mixf^l  their  ingredients  in  quantity  in  a  large 
w^KyJrji  }h>x,  UHing  a  shovel  for  trjssing  the  salts  about  till  they 
wrjre  sufficiently  mixfjd.  Many  other  illustrations  could  be  easily 
HfUlucM,  without  res'irtj'ng  Uj  the  known  facts  elicited  by  our 
metb^><ls.  As  Dr.  Cockbuni  had  lately  fallen  foul  of  Mr.  Wilson, 
he  (Dr.  Drury)  would  mention  a  case  that  made  a  very  great  im- 
pression upon  him  when  he  was  new  to  Homoeopathy,  which 
proved  more  to  his  mind  than  any  amount  of  imsupported  argu- 
ment. A  little  child,  about  two  years  old,  was  suffering  from 
congestion  of  the  lungs  and  other  mischief.  Being  only  a  begin- 
ner at  that  time.  Dr.  Drury,  in  treating  this  case,  had  obtained 
the  help  of  another  homoeopath.  For  some  days  the  child 
continued  to  get  worse,  and  a  fatal  result  threatened.  Circum- 
stances occurred  that  compelled  the  gentleman  in  attendance  to 


Consistent  vnih  Reason  and  Experience  t  35 

be  absent,  and  Mr.  Wilson's  advice  was  sought  On  seeing  the 
child  at  seven  in  the  evening,  he  at  once  said  that  it  was  a 
beautiful  Chamomilla  case,  and  would  do  well ;  the  respiration 
was  then  eighty  in  a  minute,  with  other  well-marked  symptoms. 
Chamomilla  30  was  given.  On  seeing  the  child  at  ten  the  same 
evening,  the  respiration  had  fallen  to  fifty ;  and  from  that  time 
the  disease  steadily  yielded.  This  case  showed  the  importance 
of  making  a  proper  selection,  and  also  that  the  30th  dilution 
would  act  as  effectually  as  any  other  in  acute  diseasa  That  the 
Homoeopathic  medicines  would  produce  aggravations,  was  well 
established.  He  had  on  different  occasions  seen  the  30th  dilution 
of  mercury  affect  the  mouth.  Probably,  in  these  cases,  the  mer- 
cury remaining  in  the  system  from  the  former  Allopathic  abuse 
of  the  drug  was  called  into  play  by  the  Homoeopathic  dose,  and 
so  produced  the  peculiar  action  of  the  drug.  That  syphilis  and 
gonorrhoea  might  be  successfully  treated  with  the  30th  dilution, 
there  was  no  doubt.  Some  years  ago,  he  (Dr.  Drury)  was  attend- 
ing a  case  of  anthrax,  of  enormous  size.  There  was  at  the  same 
time  a  venereal  sore,  to  which  his  attention  was  called.  Nitric 
acid  appearing  to  him  to  be  suitable  at  the  moment  for  both 
complaints,  he  gave  it  in  the  30th  dilution,  and  the  sore  healed 
as  quickly  as  it  was  possible.  He  recollected  very  well  attending 
the  brother  of  an  editor  of  an  influential  journal,  sufferii\g  from 
gonorrhoea  and  swelled  testicla  The  brother  of  the  patient  said, 
"  Well,  this  is  a  fair  case  to  try  Homoeopathy  in,  for  imagination 
will  not  cure  gonorrhoea  and  swelled  testicle."  There  was  no 
difficulty  in  treating  this  case  successfully  with  the  30th  dilution. 
Dr.  Kidd  claimed  credit  to  himseK  for  picking  out  the  good  of 
Hahnemann's  system,  and  rejecting  his  blunders.  It  had  yet  to 
be  proved  that  what  Dr.  Kidd  called  blunders,  were  so ;  on  the 
contrary.  Dr.  Eidd  appeared  to  have  missed  some  of  the  great 
truths  established  by  Hahnemann,  and  himself  deserved  the  pity 
he  was  so  ready  to  bestow  on  the  foiinder  of  Homoeopathy, — as 
by  setting  up  his  own  opinion  in  opposition  to  Hahnemann,  he 
committed  a  fatal  error,  and  lost  some  of  the  chief  good  of  Homoeo- 
pathy. He  had  asked  why  Dr.  Hale,  having  demonstrated  the 
existence  of  the  medicine  in  the  5th  dilution  by  means  of  the 
spectrum,  had  not  stopped  there.  The  answer  was  very  simple  : 
before  ever  the  spectrum  was  heard  of,  Dr.  Hale  had  become 
convinced  of  the  satisfactory  action  of  the  higher  dilutions,  and, 
like  a  sensible  man,  had  continued  to  use  them.  In  conclusion, 
he  (Dr.  Drury)  must  express  his  regret  if  anything  had  fallen 
from  him  calculated  to  wound  those  from  whom  he  differed ; 
but  when  great  truths  were  attacked,  it  was  necessary  they 
should  be  defended. 

Dr.  Wyld  observed  that  the  paper  just  read  had  rfoa\3L\»\\.  V)aa 


30  /.<  (he  Ditctrine  of  InfinitesimaU 

stain])  of  gK'at  reality.  The  autluir  was  thoroughly  in  earnest,  and 
]>n.S(:iitc(l  to  ud  a  ^ciml  illustration  of  "  tlie  fervid  genius  of  the 
Scotcli."  He  (Dr.  WyM)  could  not  mhnit  thatthe  doctrine  of  infini- 
ti'.siTiial.s,a.sproixjuniIe(n>y  Dr.  Ilaliuemann/' was  unscientific,  be- 
cansf.'  incoiiiprelieiisible."  Many  facta  in  science  were,  to  the  limited 
nature  of  human  thought,  quite  incomprehensible.   The  fact  that 
soniL'  of  the  fixed  stars  werc  millions  of  times  larger  than  our 
sun,  whilst  otlier  stars  were  s<»  tli.stant  that  their  light  took  thou- 
sands of  years  to  reach  our  earth,  \venj  scientific  facts  quite  incom- 
prelK'nsible  to  the  human  mind.     The  counter  fact  that  a  million 
of  intricately  organised  beings,  capable  of  propagating  their  race, 
might  be  all  present  in  a  drop  of  water,  was  another  scientific 
fact  lieyond  our  comprehension.    The  telescope  and  the  micro- 
scoix?  revealed  these  truths  to  our  sense  of  vision,  and  we  in 
wrjrrls  say,  that  we  know  these  facts ;  still,  they  were  facts  tran- 
scending our  powers  of  full  comprehension,  and  were,  at  least, 
far  more  inconceivable  than  the  fact  that  the  most  violent  forms 
of  discfase  could  be  controlled  by  infinitesimal  doses  of  medicine. 
Dr.  Cockbum  not  only  denied  the  reality  of  the  infinitesimal 
dose,  but  said  it  was  even,  if  true,  still  unnecessary.     But  this 
statement  could  be  at  once  answered  by  referring  to  numerous 
cases  of  scrofulous  caries  of  the  bones  being  cured  by  the  12th 
and  30th  dilutions  of  silica,  a  substance  inert  in  its  gross  form. 
Anyone  who  has  had  an  opportunity  of  judgiug,*must  know  that 
many  cases  of  disease  have  been  cured  by  our  highest  dilutions, 
which  remained  uncured  by  allopatliic  drugs,  and  low  dilutions 
of  liomoeopathic  medicines  ;  although  it  was  true  that  the  con- 
verse was  sometimes  the  case  also.    Many  diseases  run  a  natural 
course,  and  the  sceptic  refers  all  our  cures  to  this  cause ;  but  the 
most  unanswerable  argument  in  proof  of  the  actual  power  of  the 
infinitesimal  dose  seemed  to  Dr.  Wyld  to  be  drawn  from  the  fact 
that  constipation  of  the  bowels  was  frequently  produced  by  our 
remedies  when  first  taken  by  patients  new  to  Homoeopathic 
practice,  and  this  without  any  change  in  their  diet  or  regimen. 
The  discovery  by  Halmemann  of  the  power  of  the  infinitesimal 
dose  was  deeply  interesting  and  important ;  although  that  great 
genius  certainly  pushed  this  and  some  other  doctrines  into  the 
regions  of  absurdity,  thus  greatly  retarding  the  progi'ess  of  the 
greatest  reformation  ever  effected  in  medicine.    llie  doctrine 
might  be  one  contrary  to  a  priori  reasoning  and  probability ;  but 
it  was  a  doctrine  proved  to  be  true  by  the  daily  experience  of 
millions  of  educated  and  intelligent  men  and  women  throughout 
the  civilized  world. 

Dr.  Russell  said :  While  I  admire  the  courage  of  Dr.  Cock- 
bum  in  coming  up  to  London  and  boldly  throwing  down  the 
gauntlet  in  this  Society,  by  aflSrming  the  astonishing  proposition 


Consistent  with  Reason  and  Experience  ?  37 

that  the  use  of  infinitesimal  doses  of  medicine  is  opposed  to 
reason  and  experience,  and  should  be  abandoned  from  this  time, 
I  can  account  for  the  amount  of  support  his  views  have  received 
only  by  the  iogenuity  and  literary  ability  with  which  he  has 
succeeded  in  supporting  them.  It  would  be  out  of  the  question 
to  attempt  at  this  late  hour  to  follow  the  author  of  this  paper 
through  all  the  steps  of  his  destructive  argument  All  I  shall 
attempt  to  do  is,  to  point  out  what  I  conceive  the  fundamental 
errors  of  his  process;  other  speakers  have  ably  discussed  the 
errors  of  detail  into  which  he  has  fallen.  Dr.  Cockbum  began 
by  a  historical  statement  t6  this  effect : — Hahnemann's  greatest 
success  was  in  the  first  nine  years  of  his  practice — i.e.,  from  1795 
to  1804  This  success  was  obtained  from  medicines  given  in 
massive  doses,  not  in  infinitesimal  quantities.  After  he  had  in- 
vented (to  use  Dr.  Cockbum's  own  view)  his  small  dose,  his  suc- 
cess abated ;  let  us,  then,  imitate  Hahnemann  in  his  better  days, 
and  not  in  his  worst.  I  confess  I  heard  this  statement  with 
perfect  astonishment.  To  me  it  is  perfectly  new.  I  have  read 
all  that  Hahnemann  ever  published,  and  I  have  read  and  trans- 
lated about  sixty  letters  written  to  his  most  intimate  friends.  I 
have  read  almost  all  that  his  early  followers  have  written,  and  I 
cannot  recall  a  single  expression  that  warrants  such  a  statement. 
I  look  upon  it  as  a  pure  figment ;  and  how  anyone  besides  the 
author  of  this  paper,  who  seems  to  have  trusted  too  much  to  his 
imagination  for  his  historical  facts,  should  endorse  it,  is  to  me 
an  almost  greater  surprise.  Not  only  is  it  without  the  shadow  of 
support  from  any  authentic  record,  but  it  is  opposed  almost  to 
possibility,  on  Dr.  Cockbum's  own  premises ;  for  I  understand 
that  gentleman  to  avow  himself  a  staunch  adherent  of  the  law 
of  Homoeopathy,  and  to  maintain  that  it  is  only  by  discovering 
similars  that  we  can  successfully  treat  the  sick.  Dr.  Cockburn 
is  a  Homoeopathist — ^wishes  to  be  considered  such — and  objects 
only  to  the  infinitesimal  dose.  Did  it  not  occur  to  him  that 
during  the  years  which  he  fixes  as  being  the  most  successful  of 
Hahnemann's  useful  career,  he  had  not  above  some  eight  or  ten 
medicines  proved  ?  Does  Dr.  Cockbum  really  mean  us  to  be- 
lieve that,  with  a  very  few  partially  known  remedies,  Hahne- 
mann effected  more  cures  than  after  he  had  increased  his  phar- 
macopoea  tenfold  by  his  enormous  labour  ?  If  this  reaUy  were 
so,  then  indeed  the  life  of  the  founder  of  our  system — ^the  life  of 
toil  and  privation  he  led  for  twenty  years — ^was  all  spent  in  vain. 
But  is  it  so  ?  On  the  contrary,  the  testimony  of  Hahnemann, 
the  evidence  of  his  disciples,  the  universal  belief  of  aU  who  had 
an  opportunity  of  becoming  acquainted  with  the  facts, — all  are 
dead  against  the  wild  assumption  of  Dr.  Cockburn.  Indeed,  it 
seems  to  me  that  the  strangest  tiling  about  this  strange  essay  i* 


38  Is  (he  Dmtrine  of  InJiniUsimaU 

its  anaclirfjiiisin.    It  sliouLl  have  been  published  sixty  years  ago, 
b'fon*  tlioro  was  any  accuiiiuhition  of  experience  in  regard  to  Uie 
utility  of  small  dosi'fl.     To  publish  it  now  is  to  make  upon  us  no 
less  ii  tlfinainl  than  this  :  "  Gt»nth»iiien,"  Dr.  Cockbum  virtually 
says,  "  Voii  an;  all  wnm^ — you  are  labouring  under  a  delusion 
— the  HoiiKi'opathy  which  has  grown  up  in  this  century,  like 
tliat  iiii^'hty  tree  which  spning  from  a  grain  of  mustard-seed, 
ami  which   uow  spreads  its  boughs  over  the  whole  civilized 
world,  lias  been  wrongly  practised.   Give  up  tliis  system  of  prac- 
tice— I  will  demonstrate  to  you  its  insuflBciency — and  then" — 
and  th»'n  what  ?     Here  he  leaves  us  ;  we  are  to  put  our  boxes 
into  the  fire,  and  to  leave  our  patients  to  their  fate  until  Dr. 
Cockhurn  excogitates  a  system  of  medicine  which  he  can  recon- 
cile to  his  fancy  of  what  ought  to  be,  not  to  his  experience  of 
what  is.     I  call  his  paper  an  anachronism,  and  say  it  should 
have  appeared  sixty  years  ago  ;  but  this  is  not  far  enough  back 
to  thrust  it ;  it  ought  to  have  appeared  at  least  two  hundred 
years  ago,  for  it  is  really  the  paper  of  a  schoolman  before  the 
time  of  Lord  Bacon.     Its  fundamental  doctrine  is,  that  we  are  to 
find  out  by  our  unassisted  reason  what  ought  to  be  true,  and  to 
deny  everything  which  does  not  square  with  our  preconceived 
notions ;  we  are  to  deny  that  there  is  any  virtue  in  a  dose  of  the 
Cth  dilution,  because  we  do  not  understand  how  there  should  be 
any.     Such  were  the  systems  of  philosophy  before  the  time  of 
Lord  Bacon.   They  were  presumptuous  and  barren.    His  system  is 
more  modest.    He  tells  us  to  observe  phenomena  first ;  to  attempt 
to  explain  these  phenomena  afterwards.  Hahnemann  was  his  dis- 
cix>l(i ;   he  was  contented  to  observ^e  and  to  experiment.     The 
fruits  of  his  observations  and  his  experiments  have  grown  into  a 
system  of  practice  called  Homoeopathy.    All  who  practise  this 
system,  whether  they  like  it  or  not,  are  his  followers,  and  to  him, 
I  may  say,  we  owe  everything.     While  making  this  acknowledg- 
ment, I  do  not  suppose  it  can  enter  into  the  mind  of  anyone 
that  it  is  the  intention  of  any  rational  man  to  imitate  what  he 
considers  the  errors  of  the  great  master.     Of  this,  now-a-days,  in 
this  country,  there  is  little  danger ;  for,  strange  to  say,  it  seems 
the  fashion  for  some  members  of  our  Homoeopathic  body — men 
who  owe  all  their  reputation,  all  their  influence,  to  the  fact  that 
they  adopted  the  system  of  medicine  discovered  sixty  years  ago 
by   Hahnemann,   by  him  alone,   and  made  practical  by    his 
labours,  and  by  the  labours  of  his  disciples — it  seems  the  fashion 
now-a-days  to  depreciate  all  his  merits,  and  to  exaggerate  all  his 
faults.     To  read  what  some  have  written,  and  to  listen  to  what 
some  say,  one  would  imagine  that  we  had  now  grown  so  wise  as 
to  be  ashamed  of  calling  ourselves  the  disciples  of  Hahnemann. 
For  my  part,  I  can  only  say  that  the  shame  I  feel  is,  that  I  am  so 


Consistent  vnth  Reason  and  Experience  t  89 

tmwortliy  of  so  high  a  distinction ;  for  to  be  a  disciple  of  that 
great  man  implies  that  one  should  devote  his  life  to  the  labour 
of  patient  investigation  into  the  action  of  all  substances  which 
contribute  means  of  curing  disease.  Hahnemann  in  his  own 
person  did  more  by  his  life  of  toil  for  the  relief  of  humanity 
than  all  who  either  helped  or  followed  him  in  this  path.  In  my 
opinion,  it  is  as  impossible  to  exaggerate  his  services  to  medicine 
and  the  human  race  as  it  is  for  us  to  equal  them ;  but  there  is 
nothing  easier  than  exaggerating  the  errors  into  which  he  fell, 
and  really  the  amount  of  merit  of  those  who  display  their  inge- 
nuity and  bestow  their  labour  in  pointing  them  out,  seems  to 
me  quite  infinitesimal. 

Dr.  CocKBURN  said :  Mr.  Chairman,  at  this  late  hour  it*  would  be 
impossible  to  reply  to  each  individual  objection  made  to  the  paper 
read  to-night.  I  shall  take  up  the  most  important  of  them.  Dr. 
Hale  objected  to  my  second  position — ^namely,  that  infinitesimals 
were  not  demanded  by  the  requirements  of  the  organism.  He, 
Dr.  Hale,  granted  that,  as  regards  food,  infinitesimals  were  not  re- 
quired for  the  nourishment  and  growth  of  the  body ;  but  he  was 
surprised  to  find  in  this  the  nineteenth  century  that  anyone  could 
say  this  in  regard  to  disease.  In  endeavouring  to  prove  that  in- 
finitesimal doses  of  medicine  were  required  for  the  cure  of  disease, 
he.  Dr.  Hale,  unwittingly  went  on  to  show,  from  the  microscopical 
structure  of  our  bodies  and  the  theory  of  cell  development,  that 
infinitesimals  were  necessary;  but  as  medicines  do  not  go  to  form 
part  of  the  structure  of  the  organism,  nor  take  any  share  in  the  for- 
mation of  organic  cells,  the  infinitesimals  required  for  this  purpose 
must  be  infinitesimal  quantities  of  food — ^the  very  thing  he 
granted  was  not  required.  He  also  stated  that  the  fact  of  there 
being  no  analogy  between  health  and  disease  was  fatal  to  my 
position ;  but  I  had  nowhere  made  any  such  statement  that  an 
analogy  of  this  kind  existed.  I  had  shown  that,  in  regard  to 
health,  the  food  required  for  the  nourishment  of  the  body  must 
in  its  constitution  be  similar  to  that  of  our  own  bodies  ;  that 
in  disease,  the  medicine  to  cure  must  be  one  which  is  capable  of 
acting  on  the  body  in  a  way  similar  to  the  disease ;  and 
that  in  these  respects  there  was  an  analogy.  Also,  that  in  health 
infinitesimal  quantities  of  food  were  not  required  for  the  nourish- 
ment of  the  body  ;  and  that  in  the  cure  of  disease,  infinitesimal 
quantities  of  medicine  were  not  required ;  and  that  in  this  re- 
spect also  there  was  an  analogy.  No  argument  had  been  ad- 
vanced against  these  positiona  Eeference  had  been  made  to  the 
wonders  revealed  by  the  spectrum  analysis,  but  I  can  see  no 
support  which  these  give  to  the  doctrine  of  infinitesimals.  And 
^bearing  in  mind  the  lesson  taught  by  Rutter's  magnetoscope,  I 
think  we  ought  to  be  cautious  how  we  attempt  to  bob>tfcx  >\^  ^ 


40  lb  Ui€  Dm'trint  of  IiifinitmrnaU 

doubtful  doctrine  hy  such  a  novi-lty.  While  accepting  the  cor- 
r«M;tii»'h.s  of  the  analysis  ciualitatively,  I  suspect  there  is  an  error 
(Hiiiif'ctt'd  with  tliii  caK'ulat  ions,  which  guuu  the  assumption  that 
whi  II  oiK'piiin  of  c}iloiid(Mit*s«Mliuni  is  burnt  in  a  room,  the  sodium 
i^iwiko. Jiils  the  itioni.  I  «^n*ant  that  it  maybe  equally  diffused 
throiiijhnut  tlie  atnins]i]icre  in  the  room  ;  but  it  cannot  fill  the 
r<ioni  without  first  nustin*{  the  wliole  atniosjiheric  air  present: 
jin<l  not  only  sn,  Imt  it  wuuM  n^quin^to  oust  the  whole  furniture 
jir< -^i-iit.  Tlic  (|uantity  of  atmospheric  air  in  the  room,  as  well 
as  all  th(r  iurnitun*,  must  i-citn-scnt  so  much  sitace  where  there  is 
IK)  cliloride,  it  ])tMii|r  imi»o.s.sible  fur  any  two  bodies  to  exist  in 
tli*i  saiiK-  sj)ace  lit  tin*  sanui  time.  Fn»m  all  those  experiments, 
\\i)\\c\i:\\  it  would  a])pear  that  the  chU»ride  of  sodium  exists  as  a 
con.*,taiit  iii;jn*dii!nt  in  the  atmosphere,  in  a  quantity  perhaps 
i'.(\\\'A  to  our  Snl  or  4th  potency,  and  that  many  other  sub- 
fttaij(;(:.s  U-sidcs  the  chloride  are  also  present.  Look  at  the  silica 
conslaiilly  tritunited  on  our  footpaths  and  highwaj'S,  driven  by 
til' J  wiiid:^,  and  inhaled  by  everyone — look  at  the  iron,  the  copper, 
aii'i  ilii;ziiic,  from  the  ])euches  of  a  thousand  artizans,  carried  by 
iIkj  \,Ti'M'/A'.ii  in  eveiy  direction — ^look  at  our  <lrug  mills,  chemical 
woilcH,  i\r\\\!^  shops,  and  lalx)ratories,  on  every  side  of  us,  con- 
Htautly  prjurin;^  forth  large  quantities  of  powerful  and  deleterious 
iiiat'rj'ial.  Wliat  effect  can  globules  of  the  30th  potency  have  in 
tij';  pKis^-nce  of  th(;se  higher  activities?  Halmemann  never 
ilr*:aiijt  of  the  siMH;tniin  analysis ;  but  taking  the  drift  of  his  rea- 
bonin;(  in  coimecticjii  with  these  potencies,  there  is  not  a  shadow 
ii\'  a  doubt  that  he  looked  upon  the  use  and  efficacy  of  these 
pot^'lK:i'^s  as  Ixdiig  in  the  highest  degree  inconsistent  and  incom- 
patil)l<;  will  I  the  \)X<t^iiQ>Q  of  any  disturbing  agency  in  the 
organism  at  the  same  time.  And  on  this  account  he  not  only 
institiitfjd  a  most  rigorous  diet,  but  insisted  on  the  removal  of 
rivt^rytliiiig  that  could  exercise  any  influence  of  a  drug  nature  on 
tlio  Ixxly.  I^ut  while  he  could  banish  the  coffee  and  the  tea,  the 
tooth-powder  and  the  perfumery,  who  could  remove  the  chloride 
of  sodium  from  the  atmosphere,  or  sweep  away  those  other 
nuni(;rous  agents,  the  presence  of  which  is  now  being  revealed 
to  us  by  the  sjjectrum  analysis?  When  the  facts  become  more 
matured  and  numerous,  I  look  to  this  mode  of  analysis  as  being 
liktily  to  furnish  us  with  a  powerful  argument  against  the  use  of 
th<j  inlinitesiinala  Dr.  Hamilton  argued  that  there  was  an 
analogy  between  the  infinitesimals  and  the  different  miasms, 
and  that  tlui  power  of  the  latter  proved  the  power  of  the  former. 
I  can  H(U!  no  analogy  here.  Anedogy  can  be  predicated  only  on 
thri'c'  grounds — first,  analogy  in  regard  to  kind;  second,  analogy 
in  ivgard  to  (piantity ;  and  third,  analogy  in  regard  to  power. 
l-'iiMl.,  in  n^gard  io  kind.     As  no  one  has  ever  succeeded  in  dis- 


Consistent  wUh  Reason  and  Faperience  f  41 

-covering  the  nature  of  the  miasms,  we  are  not  warranted  in 
assuming  that  anything  else  has  any  analogy  to  them  in  kind. 
Second,  in  regard  to  quantity.  We  do  not  know  in  what  particular 
form  the  the  miasms  exist ;  but,  assuming  that  they  exist  in  a 
gaseous  form,  is  it  not  reasonable  to  suppose  that  this  gaseous 
material  is  diffused  through  vast  tracts  of  the  atmosphere,  and 
that  an  individual  exposed  to  this,  inhales  large  volumes  of  it 
at  every  inspiration  ?  Is  there  any  analogy  in  quantity  between 
that  and  the  supposed  infinitesimal  quantity  of  drug  in  a 
globule  of  the  30th  potency  ?  To  me  there  seems  to  be  a  great 
contrast.  Or,  supposing  that  the  miasm  exists  in  the  form  of  solid 
atoms,  is  it  not  reasonable  to  suppose  that  these  are  spread  over 
immense  districts,  and  that  a  person  exposed  to  it  must  inhale 
millions  and  millions  of  these  ?  Is  there  any  analogy  between 
that  and  the  quantity  of  drug  supposed  to  exist  in  a  liliputian 
globule  of  the  30th  potency  1  There  seems  to  me  to  be  a  pro- 
digious contrast.  Third,  in  regard  to  power.  Is  there  any 
analogy  between  the  power  of  the  pestilence  that  walketh  by 
noonday  and  that  spreadeth  abroad  its  terrors  by  night ;  that 
makes  our  homes  desolate,  and  fills  our  graveyards  with 
blackened  corpses — ^any  analogy  between  that  and  a  globule  of 
the  30th  potency  ?  The  very  idea  is  absurd.  My  friend  Dr. 
Eussell  has  made  a  very  full  and  elaborate  defence  of  the  doctrine 
of  infinitesimals  on  the  general  ground  of  experience.  This 
appears  to  me  to  be  the  stronghold  of  the  doctrine ;  but  what 
does  it  mean  ?  Is  it  meant  that  experience  proves  the  efficacy 
of  all  the  potencies  in  all  diseases  ?  No.  Is  it  meant  that  ex- 
perience proves  the  efficacy  of  ail  the  potencies  in  some  diseases? 
No  :  for  many  of  the  potencies  have  never  been  tried.  Is  it 
meant  that  experience  proves  the  efficacy  of  some  of  the  poten- 
cies in  all  diseases  ?  No.  I  take  it,  therefore,  that  it  must  mean 
that  experience  proves  the  efficacy  of  a  limited  number  of  the 
potencies,  not  amounting  to  a  fourth  of  the  whole,  in  a  limited 
number  of  diseases.  But  this  is  something  very  different  from 
that  which  is  implied  in  the  general  objection.  And  then,  even 
though  it  had  assumed  this  modified  form,  I  should  have  sought 
to  know  what  it  was  that  led  to  the  choice  of  the  special  potency 
in  the  special  case  :  why  it  was  that  thirty  was  chosen  in  place 
of  twenty-nine  or  thirty-one  ;  why  sixty  was  riosen  in  place  of 
sixty-one  or  fifty-nine;  why,  in  a  word,  any  one  particular 
potency  was  chosen  in  place  of  the  one  immediately  above  or 
immediately  below.  The  answer  to  this  is  vital  in  the  case. 
And  I  know  that  no  one  can  give  any  rational,  or  scientific  state- 
ment as  to  what  ought  to  decide  the  special  choice.  This  being 
the  case,  we  would  require  still  further  to  modify  the  objection, 
which  would  stand  thus  : — That  experience  proves  the  effic*" 


42  Is  the  Doctrine  of  InfinxtmmaU 

a  liniitod  number  of  potencies,  not  amounting  perhaps  to  a 
fourth  of  the  whole,  in  a  limited  number  of  diseases,  and  that 
unfh.T  c()n(iiti(ms  and  circumstances  totally  undefined  and  un- 
dcfiiialjle.  I  can  see  no  force  in  an  objection  like  this.  But 
it  ii])pears  to  mu  we  arc  on  very  dangerous  ground  in  making 
our  ap]K?al  to  experience.  As  Homoeopaths  we  have  always 
felt  our  superiority  over  our  opponents,  and  been  able  not 
only  to  refute  every  objection  advanced  against  our  system, 
but,  without  any  flattery,  I  may  say  we  have  been  able 
to  vanquish  our  opix)nents;  and  this  we  have  been  able  to 
do  solely  on  the  ground  that  our  mode  of  practice  was  based 
on  law  and  consistent  with  reason.  But,  in  making  our 
appeal  to  experience,  we  lose  our  vantage  ground,  and  place 
ourselves  on  the  very  same  level  with  every  pretender  and 
empiric  in  medicine.  Look  to  our  HoUoways  and  Morrisons, 
our  Parrs  and  our  Perrys — ^they  all  make  their  appeal  to  expe- 
rience. I  know  that  experience  is  the  grand  test  and  touchstone 
of  every  system  and  every  science,  but  in  the  doctrine  of  infi^ 
nitesimals  we  have  no  system  and  no  science  to  which  we  can 
apply  the  test.  It  appears  to  me  that  it  is  not  possible  that 
experience  can  prove  the  efl&cacy  of  the  infinitesimals,  and  for 
this  reasoa  You  will  all  agree  with  me  that  in  every  practical 
subject  in  which  a  practical  test  can  be  applied,  it  is  absolutely 
necessary  for  the  individual  applying  the  test  to  make  himself 
thoroughly  acquainted,  not  only  with  the  nature  of  the  thing  to 
be  done,  and  to  know  that  he  can  do  that,  but  he  must  also 
make  himself  thoroughly  acquainted  with  the  condition  and  cir^ 
cumstances  on  which  the  success  of  the  experiment  depends, 
and  act  up  to  these.  This  is  imperative  in  every  science.  Why 
is  it  that  we  have  been  obliged  to  reject  the  experiments  of 
Andral  as  to  the  truth  of  Homceopathy  ?  Why  have  we  been 
able  to  refute  these  ?  Not  because  Andral  did  not  imderstand  the 
Homoeopathic  formula;  not  because  he  knew  nothing  about 
Homoeopathic  remedies ;  but  simply  and  solely  because  the  coii- 
ditions  and  circumstances  on  which  the  success  of  every  such  ex- 
periment depended  were  grossly  violated  in  his  case.  And  just  so 
here.  The  conditions  and  circumstances  on  which  the  success 
of  the  potencies  depends  being  unknown  and  undefinable,  I  hold 
that  it  is  impossible  to  apply  a  rational  experiment  in  the  case ; 
and  as  no  rational  experiment  can  be  applied,  no  one  is  wiEUV 
ranted  in  saying  that  experience  proves  their  efficacy.  I  shall 
not  say  what  may  not  be  proved  by  empirical  experienca 
Though  no  rational  experiment  can  be  made  with  the  infinitesi- 
mals, we  find  that  they  are  daily  used,  and  there  must  be  some 
reason  for  it  Infinitesimals  can  be  employed  only  on  three 
grounds :  1st,  on  the  ground  of  authority ;  2nd,  on  the  ground 


Consistent  with  Reason  and  Experience  i  43 

oi  precedent ;  and  3rd,  on  the  ground  of  empiricism.  The  1st 
we  have  embodied  in  Hahnemann ;  the  2nd  in  the  earlier  dis- 
ciples ;  and  the  3rd  in  some  of  the  present  race  of  Homoeo- 
pathists.  1st  As  to  the  ground  of  authority.  Hahnemann's 
experience  has  been  divided  into  two  sections — ^namely,  his 
earlier  and  later  experience ;  and  from  the  far  greater  success  of 
the  latter  over  the  former,  it  has  been  assumed  that  he  was  war- 
ranted in  dogmatically  teaching  that  the  30th  potency  was  the 
only  proper  dose  always  to  use.  There  can  be  no  doubt  that 
Hahnemann  was  successful  during  the  first  nine  years,  when  he 
practised  Homoeopathy  with  large  doses.  He  was  not  ashamed 
of  his  success  then,  but  from  time  to  time  published  highly  in- 
teresting records  of  successful  cases— cases  which  he  believed 
were  calculated  not  only  to  prove  the  truth  of  Homoeopathy, 
but  which  were  likely  to  gain  converts  to  the  new  system. 
To  an  unprejudiced  mind  it  is  rather  a  suspicious  circumstance 
that  he  should  publish  no  further  records  after  the  introduction 
of  infinitesimals.  But  successful  as  Hdmemann  was  during 
the  first  nine  years  of  his  experience,  we  would  reasonably 
expect  that  he  should  be  more  successful  in  his  later  yearsL 
We  would  expect  at  least  a  twofold  increase  of  success.  First, 
we  would  look  for  an  increase  of  success,  as  the  number  of  reme- 
dies increased ;  and,  second,  as  he  became  more  fully  acquainted 
with  the  curative  powers  of  the  different  remedies.  And  it 
would  be  an  interesting  subject  of  inquiry  to  find  out  if  Hahne- 
mann's later  experience  actually  came  up  to  this  requirement 
I  do  not  deny  that  it  did.  But  it  is  assumed  by  some  that  we 
have  not  only  this,  but  that  we  have  a  threefold  increase  of 
success  by  the  introduction  of  the  infinitesimals.  It  is  this 
assumption  which  I  call  in  question ;  not  a  particle  of  evidence 
has  been  adduced  to  prove  the  truth  of  this.  That  the  extensive 
records  which  he  collected  for  forty-three  years  after  the  intro- 
duction of  infinitesimals  do  contain  a  great  amount  of  material 
which  would  be  of  great  importance  to  Homoeopathy,  I  do  not 
doubt ;  but  that  these  records  refer  to  diseases  more  deadly  or 
more  dangerous  in  their  character — ^that  they  refer  to  cures  more 
striking  and  more  rapid — or  that,  in  a  word,  they  contain  evidence 
more  convincing  and  more  demonstrative  of  the  truth  of  Homoeo- 
pathy than  those  published  in  '96  and  '98, 1  cannot  believe,  and, 
considering  the  importance  of  the  assumption,  and  inference  to 
be  drawn  from  it,  I  dare  not  believe  without  the  most  unequivocal 
proof.  However  much  anyone  may  differ  from  Hahnemann  on 
some  minor  points,  no  one  can  for  a  moment  doubt  his  sincerity,  or 
imagine  that  he  would  leave  one  stone  unturned  that  was  likely  to 
advance  the  cause  he  advocated.  But  to  say  that  he  had  in  his 
possession  for  upwards  of  forty  years  such  a  mass  of  material* 


i'  • 

...' 

I"* 

t.',: 

i  '.\ 

ti''ti 

:.'iji 

lit,'- 

i'  ' 

).'■ 

4  i  In  tht  Th^.trxM  of  Infinittsimah 

^'.f. *:...::.;'  t}j;,t.  v'Tv  fvuh-Tiff'  iijirm  which  the  conversioii  of  the 
ifi!  t|j"  j.nff-riori  to  thf;  faith  auil  practice  of  Hoxnoeo- 
r.;:.:i!v 'Ji|.<rifl<rrl,  nii'I  tlint  yet  he  withheld  the  publica- 
t}i;iV  i-i  «*j*ji'i-*i|  to  fill  I'vjili'iicp.  I  can  look  upon  Hah- 
I  .1  -  \f\u*j  ;iri  hoiif.st  man,  and  reconcile  the  fact  of  hia 
!;  lijii:.'  tli<  .<•  vtuiiX^  only  on  the  understanding  that,  as 
'  ^:[j'  v.-  -aIi;.!  tli*  y  r  r,ijtaiii»-d,  h«*  n-ally  lx?lieved  that  their 
J. .'...  I'.'iii  -Aoul'l  [j'jt.  In-  fi»r  tli<:  lif-nefit  of  Homoeopathy.  I  can 
\'utv\',\f  -.w-  no  ;ii;.'inij'ijt  in  favour  rjf  tlie  infinitesimals  that 
t '.lu  \,*'  '\ii\Au  \vu\\\  Hiiliii'inainr.s  later  exx)eriencc.  Second,  as 
f/»  W.f  '/\',\\ut\  of  [in-n-di'iit.  Some  Ifoniri'opathists  are  con- 
;t;M.t;v  ;,...../. riiii;#  tJi;it  the  f-arlier  di^H;ilJ^*s  were  more  successful 
t}i;iji  \\\',\t\  now  living'  are;  hut  no  pniof  has  been  given  for  this 
u\'.i\Uttu.  I  \}t'\\i:\i\  it  is  jMin'ly  apocryphal.  God  forbid  that  I 
^■.lionl'l  ■■.;iy  one  word  (liMpani«(in;4ly  of  those  noble  men;  we  are 
fill  intiiWy  iu'lebtird  to  theia  I  lionour  them  for  their  work's 
wik<',  aM'i,  w' re  they  now  jiresent,  would  most  heartily  sympa- 
i\iy\i\  with  them  in  tiie  Huffcriui^s  and  pei*secutions  which  most  of 
th'-jM  rriMMt,  have  unrh'i-^one  in  tlie  defence  of  the  truth.  But 
fojfiid  that  any  of  uh  sliould  substitute  either  a  Paul  or  an 
Apollo:',  ill  t.hr;  jilace  of  truth  itsdf.  Tlie  assumption  that  the 
i'iuVM'Y  i\m'\\ih*H  were  more  Hncee.ssful  than  we  are,  and  the  infe- 
renri!  drawn  then^from,  I  eannot  but  look  upon  as  an  unfortunate 
atU'Mijit,  to  im|HiHe  u|K»n  uh  tlic:  doctrine  of  individual  authority 
in  thi*  \}\\\v.i\  of  I^iw  and  ilij^dit.  Tint  I  trust  that  all  who  know 
whdt,  Lnw  nnd  Hi^dit  mc'an,  and  who  feci  the  moral  obligations 
nnd*r  whicJi  tJii-y  lie  to  thcHo,  sliall  resist  every  attempt  to 
hav«'  iirijiofwd  upon  them  any  otlier  higher  authority.  Thiid,  as 
to  th*'  j^, round  of  (MnpiricJHm.  The  essential  difference  between 
llonio(»|»nihy  and  Alloi)alhy  lies  here, — ^tliat  in  Homoeopathy 
ihi'n-  \\s  a  law,  by  the  jrui<hinee  of  which  we  cAn,  with  confidence 
and  ccrlainty,  eome  to  a  knowled<^M».  of  tlie  tnie  curative  remedy 
in  any  curable  cane.  In  Alloi)athy  thei'e  is  no  such  law;  but  in 
\\\\\  alificncn  of  Uuh  Mich!  an?  c.ei'tain  rules  and  guides  which  we 
nmy  I'ornialirtct  aH  Mm  theory  of  nh  vsus  in  morhu  The  theory  of 
ah  it.'iitnin  vinrhi,  and  the  law  w/nVm  smi7/6w5,  constitute  the 
diHliiM'Mve  liadj^i'H  of  the  two  o])posing  schools.  The  practical 
applieatiou  of  the  ironinM)])athic  law,  in  so  far  as  the  choice  of 
the  remedy  \h  concerned,  is  unity  and  harmony ;  the  practical 
applienfion  of  the  Allopatliie  theory  is  disunion  and  contradic- 
tion. And  wo  hold  that,  ho  long  as  tliis  false  theory  is  acted  on, 
we  can  have  nothing  but  contradiction  and  disunion.  But  aUthis 
rout  nidiet  ion  and  all  this  disunion  we  attribute  not  to  any  want  of 
skill,  not  to  any  want  of  knowleilge,  not  to  any  want  of  sincerity 
ow  the  |Mirt  of  the  individual  practitioner,  but  we  trace  solely  and 
lUnvtly  to  the  inherent  llaUacy  of  the  theory.     But  while  the 


Consistent  with  Reason  and  Experience  1  45 

Allopath  chooses  his  remedy  by  the  false  theoiy  of  db  usm  in 
morbi,  the  Hahnemannian  Homoeopath  chooses  his  dose  by  the 
very  same  theory  ;  and  all  the  disunion  and  all  the  contradiction 
that  prevails  in  Allopathic  practice  is  thereby  introduced  into 
the  practice  of  Homoeopathy,   and  I  fear  very  considerably 
intensified.  And  it  cannot  be  otherwisa    A  theory  which  is  in  its 
very  nature  fallacious,  can  never  change  its  character  to  ac- 
commodate the  particular  fancies  of  any  sectary.   If  observations 
made  upon  the  sick  constitute  a  true  and  a  safe  guide  in  medical 
practice,  then  let  us  be  honest  and  say  sa    If  so,  we  must  cease 
finding  fault  with  the  Allopath  for  being  guided  by  this.     But 
if  these  do  not  constitute  a  true  and  a  safe  guide,  then  let  us  be 
consistent  and  abandon  it.     The  spirit  of  Homoeopathy  demands 
this.     Homoeopathy  has  to  do  with  law,  with  ascertained  natural 
phenomena,  and  not  with  empirical  experience.   In  Homoeopathy 
we  believed  we  had  found  a  system  which  was  based  upon  law 
and  consistent  with  reason.     And  having  done  so  much  and 
suffered  so  much  in  behalf  of  our  cause,  shall  we  now  introduce 
into  our  theory  and  practice  the  very  error  against  which  we 
have  so  strenuously  and  so  successfully  protested  ?    Are  we  now 
prepared  to  confess  to  the  public  and  the  profession  that  while 
we  have  a  law  to  guide  us  in  the  choice  of  the  true  curative 
remedy,  we  have  nothing  but  empirical  experimentation  on  the 
sick  to  guide  us  in  their  application?     Forbid  that  this  ever 
should  be  so.     Hahnemann  has  taught  us  the  true  use  of  em- 
pirical experience,  by  making  it  subservient  to  the  development 
of  some  grand  general  principle.     He  seized  hold  of  the  em- 
pirical experience  of  the  past,  and  made  it  instrumental  in  sub- 
stantiating the  truth  of  the  discovery  he  had  made.     Let  us 
follow  his  example,  not  by  becoming  empirics,  but  by  using  the 
experience  of  others,  and  our  own  also,  in  the  development  of 
some  great  general  principle  for  the  regulation  of  the    dose. 
This  is  our  task.    Hahnemann  discovered  the  law  which  guides 
to  the  choice  of  the  right  kind  of  medicine ;  it  is  for  us  to  dis- 
cover the  law  which  guides  to  the  choice  of  the  right  quantity. 
Let  us  strive  to  accomplish  this. 

Dr.  Chapman  (in  the  chair) :  We  are  much  indebted  to  Dr. 
Cockbum  for  coming  such  a  distance  to  read  his  paper  to  us,  and 
the  more  so  as  this  is  his  first  visit  to  London.  We  also  con- 
gratulate ourselves  on  having  a  man  among  us  of  such  ability. 
He  is  a  brave  and  bold  man,  too,  to  assert  in  this  Society  of 
Homoeopathists  that  the  doctrine  of  infinitesimals  is  inconsistent 
with  reason  and  with  experience.  His  mind,  it  would  seem,  has 
a  greater  tendency  for  metaphysics  than  for  physics.  Is  the 
doctrine  of  infinitesimals  inconsistent  with  or  opposed  to  Eeason? 
What  Eeason,  or  the  reasoning  faculty  of  what  individual,  does 


46  h  (he  Doctrine  of  InfinitmmaU 

tlio  in^'oniuus  autlior  rcTor  to?  One  man's  Reaaon,  or  what  he 
supjioscs  to  l>e  such, diflVrs  from  another's.  The  highest  Season, 
in  its  infijiit«^  chanictur,  is  unapproachable  by  us.  The  highest 
reasoning;  faculty  of  any  ^ift<Ml  human  being  is  far  away  firom 
th(*  (.'oiiiprchcnsion  of  tlit^  i^reat  bulk  of  mankind.  It  is  a  thing 
reiiiott*.  like  some  "  brij^ht  particuhir  star."  Who  of  living  men 
has  souniltMl  the  (Io])tlis  and  shallows  of  Kant's  logic?  How 
many  or  the  numerous  mathematicians  of  the  world  have 
mastVrcrl  the  subtle  analyst^s  ^  of  Nt^wton  and  La  Place  t  No 
man  has  a  ri^ht  to  say — "Sic  vcdo,  sic  juIkjo;  stet  pro  ratione 
voluntfis." — ("  I  am  Sir  Oracle,  and  when  I  speak  let  no  dog 
bark.")  It  comes  to  this,  that  the  doctrine  of  infinitesimals  is 
inconsist(.'nt  with  the  reasoning  faculty  of  the  author  of  this 
essay ;  but  it  is  a  non  sequitur  to  assume,  therefore,  that  it  is 
inconsistent  witli  pure  reason,  with  pure  logic.  All  that  is 
worthy  of  the  name  of  science  moves  in  the  direction  of  this 
doctrine.  The  "  infinitesimal  increments  "  of  Newton,  the  "atomic 
theory  "  of  Dalton  and  the  advanced  chemists,  the  discoveries  of 
the  great  Dane  Oersted  in  reference  to  light  and  electricity — ^the 
wire  that  flashes  a  message  over  half  the  globe — are  iUustia- 
tions  of  the  infinitesimal.  The  Infinite  uses  infinitesimals  ia  the 
creative,  conserving,  and  re-constructing  exercise  of  His  autonomy^ 
and  autocracy.  This  doctrine,  which  Dr.  Cockbum  laughs  to 
scorn,  not  only  pervades  with  its  golden  threads  all  true  science, 
but  also  all  nature.  You  find  it  in  the  scents  of  different 
flowers,  in  the  colours  of  the  shells  of  the  shore,  in  the  infini- 
tesimal difference  between  the  constituents  of  an  active  poison 
and  a  harmless  thing,  as  in  the  bitter  and  sweet  almond,  the 
bitter  and  sweet  cassava.  The  doctrine  of  infinitesimals  is  the 
very  key-stone  of  true  philosophy.  Dr.  Cockbum  also  laughs  to 
scorn  the  analogy  between  the  atoms  that  spread  plague  and 
pestilence,  and  the  atomic  doses  of  medicina  There  is  nothing 
whatever  to  laugh  at,  for  the  fact  remains.  A  single  drop  of 
water  in  a  part  of  the  brain  where  no  water  should  be,  has 
before  this  extinguished  the  brightest  faculties  of  the  human 
being.  An  atom  will  cause  disease,  and  kiU.  It  is  clear,  there- 
fore, that  the  doctrine  of  infinitesimals  is  not  inconsistent  with 
Eeason.  Passing  from  the  higher  logic  of  pure  and  abstract 
Reason  to  the  "logic  of  facts,"  a  very  inexorable  thing,  we  are 
startled  by  another  thoroughly  imwarrantable  assertion  of  Dr. 
Cockbum — ^that  experience  is  without  value — ^a  dangerous  thing 
to  appeal  to  or  to  rely  on.  Bacon,  who  dedicated  his  great 
works  to  posterity,  observed  that  Time,  which  blots  out  opinions 
and  comments  (the  figments  of  Dr.  Cockbum),  confirms  and 
establishes  experienca  Is  experience  to  go  for  nothing,  because 
our  estimable  and  able  colleague  so  wills  it  1    Hippocrates  has 


Consistent  wUh  Reason  and  Experience  t  47 

been  mentioned.  On  what  does  his  r^utalion  rest  ?  On  his 
admirable  clinical  observations,  as  fresh  and  as  valuable  to 
those  who  can  avail  themselves  of  them  as  they  were  two 
thousand  years  ago,  when  Pericles  "lightened  and  thimdered " 
over  Greece.  On  what  does  the  reputation  of  Sydenham  rest  ? 
In  like  way,  on  his  admirable  clinical  observations.  Our 
essajdst  has  spoken  somewhat  slightingly,  and  so  irreverently,  of 
our  founder.  Samuel  Hahnemann.  He  says,  "Hahnemann 
discovered  the  law  of  Homoeopathy,  and  invented  infinitesimals." 
Hahnemann,  in  point  of  fact,  did  not  discover  the  law  of  Homoeo- 
pathy, nor  did  he  invent  infinitesimals.  In  one  of  the  writings 
attributed  to  Hippocrates,  it  is  distinctly  stated  that  some 
diseases  or  disorders  are  better  treated  on  the  doctrine  of 
"  similars,"  and  others  are  better  treated  on  the  doctrine  of  "  con- 
traries." Suetonius,  in  his  "  lives  of  the  Twelve  Caesars,"  stated 
that  the  Emperor  Augustus  was  unsuccessfully  treated  ac- 
cording to  the  law  of  Similars,  and  was  cured  according 
to  the  law  of  Contraries.  In  the  introduction  to  his  "  Organon," 
Hahnemann  accumulates  proofs  that  the  law  of  Similars  had  been 
more  or  less  recognised  through  all  the  cycles  of  genuine  medical 
history.  With  his  prodigous  learning  and  his  insatiable  in- 
dustry, he  collected  an  immense  amount  of  facts ;  he  brought 
them  all  to  the  test  of  the  law  of  Similars,  and  found  all  were 
included  under  that  law.  like  a  man  of  true  philosophical 
genius,  he  came  to  his  conclusion,  and  proclaimed  the  law  of 
Similars  as  the  law  of  drug-heali'tig.  This  was  quite  irrespective 
of  dose,  and  brings  us  to  Dr.  Cockbum's  charge,  that  he  invented 
infinitesiToals.  As  infinitesimals  have  always  been,  from  first  to 
last,  he  could  hardly  have  invented  them  for  his  therapeutics. 
Hahnemann  attended  a  patient  with  severe  cholera  before  the 
irruption  of  Asiatic  cholera  from  the  Delta  of  the  Ganges.  Ac- 
cording to  his  law,  he  gave  her  veratrum.  She  nearly  died  from 
intense  aggravation  of  her  disease.  He  was  a  thinking  man ;  he 
had  some  experience,  and  a  magnificent  reasoning  faculty — so 
he  reduced  his  doses,  and,  by  gradual  stages,  got  to  his  infinitesi- 
mals. The  continued  reduction  was  with  him  a  matter  of  expe- 
riment. Dr.  Cockburn  has  asserted  that  Hahnemann,  during 
his  first  nine  years  of  practice,  while  he  was  supposed  to  use  only 
crude  doses — ^not  the  slightest  proof  adduced — won  his  reputa- 
tion, and  that  it  thereafter  became  "  small  by  degrees,  and  beau- 
tifully less."  Not  the  slighest  proof  of  this  very  rash  assertion 
has  been  produced.  The  fact  is  quite  the  other  way.  Hahne- 
mann never  published  more  than  three  cases.  Dr.  Cockburn, 
without  saying  whether  he  believed  in  mesmerism  or  not,  im- 
plied that  Hahnemann  was  a  powerful  mesmerist  The  few 
pages  which  he  devotes  to  this  subject  in  the  "  Organon  "  show 
that  Hahnemann  had  not  really  paid  much  attention  \a^  tcl^^- 


48  Tx  the  Doctrine  of  Infinitcsiinah 

iiifrisiii.  Dr.  Cocklmrn  has  sneered  at  aggravations  for  high 
dilutions.  A  Live]*|>ool  merchant  consulted  Dr.  Chapman.  He 
g;iv(;  him  two  or  three  globules  of  opium  30.  The  x>atient  did 
not  know  what  he  had  Uikcn.  He  canio  the  next  morning,  and 
Siiid, ''  You  gave  me  o])ium  yostenlny,  and  I  suffered  the  worst 
o]>iiini  symptoms/'  wliich  he  gra])hically  described.  A  relation 
of  th(;  Cliairman  was  subjc^ct  to  violent  and  even  terrible  tetanic 
conviilsi(;ns  at  the  times  of  the  catamonial  period.  She  despised 
Homoeopathy,  and  said  there  was  nothing  in  it  He  was  on  a 
visit  to  her,  and  sh(i  had  the  forewarning,  one  night,  of  one  of 
tln*se  attacks,  and  she  said  to  him,  "  I  will  try  your  nonsense." 
She  had  two  or  three  globules  of  belladonna  30.  She  was  gene- 
rally confined  to  her  bed-room  several  days  from  the  conse- 
cpiences  of  this  sort  of  attack.  She  had  no  notice  of  what  had 
been  given  to  her.  She,  contrary  to  all  expectations,  was  at  the 
breakfast  table  the  next  morning,  and  at  once  said,  "You  gave 
me  belladonna  last  niglit.  Dr.  Baron  (the  biographer  of  Jenner) 
gave  it  to  me  some  years  ago,  and  he  told  me  he  gave  it  to  me 
in  sncli  a  dose  as  he  would  give  to  a  baby.  I  was  horribly  dis- 
tnisscd.  The  dose  you  gave  me  last  night  produced  the  same 
results.  I  would  far  rather  suffer  the  torture  of  the  tetanic 
misery  than  that  of  belladonna.  I  was  seeing  the  figures  of 
naked  men  all  the  night  long."  Tlie  lady  wheeled  about.  She 
no  longer  laughed  at  Homoeopathy,  but  she  says  we  use  only 
subtle  poisons  in  very  concentrated  forms.  He  (the  Chairman) 
thought  that  Dr.  Cockburn's  argument  had  entirely  failed. 
To  use  the  Cambridge  phrases — cadit  qicocstio,  cadit  argv/nun- 
turn.  The  real  fact  remains,  that  the  doctrine  of  infinitesimals 
is  thoroughly  consistent  with  reason  and  with  experience.  I 
hold,  in  conclusion,  that  the  dodmiie  of  infinitesiinaU  is  tho- 
roughly consistent.  Dr.  Cockbum's  paper,  however,  will  do 
good — has  done  good — for  it  shows  the  gross  drug-givers 
that  they  are  dmfting  into  Allopathy.  We  have  present  this 
evening  those  who  use  gross  doses  and  those  who  carry  their 
prejudice  in  the  other  direction — to  only  reinote  injinitesimals. 
All  extravagances  perish.  We  must  not  relinquish  accurate 
observation  and  large  experience  for  the  pursuit  of  a  phantom, 
born  of  the  crude  fancies  of  a  metaphysician.  The  experience  of 
HomoDopathists  in  general  during  the  last  sixty  years  is  worth 
infinitely  more  than  crude  assertion  or  idle  theory. 

Note  by  Db.  Cookbuhn.— The  subject  introduced  by  Dr.  Hale  is  contained  in 
one  of  the  portions  omitted  from  this  printed  report  of  my  paper.  The  argument, 
however,  essentially  was  this — the  Ipecncuan  in  the  illustration  I  gave  was  actaally 
present  in  the  attnosphere,  and  did  actually  produce  drug  symptoms;  this  was  sot 
denied.  But  while  this,  and  aU  sncli  like  cases,  proved  that  very  small  qnantitiai 
of  the  material  drug  did  act,  no  amount  of  such  cases  could  give  any  support  to 
the  idea  that  the  30lh  potency  of  the  same  drug  had  any  effect,  or,  indeed,  that  it 
contained  any  of  the  drug  at  ful. 


49 


ADDRESS  OF  THE  PEESIDENT,  DR.  QUIN, 

AT   THE 

ANNUAL  ASSEMBLY  OF  1863. 

Gentlemen, — The  British  Homoeopathic  Society  has  now 
entered  the  twentieth  year  of  its  existence.  During  the  whole 
of  this  period  I  have  been  honoured  by  your  repeated  election 
of  me  as  your  President,  and  until  within  the  last  two  years  I 
have  hardly  ever  been  absent  from  one  of  the  Societ/s 
meetings;  latterly,  however,  from  fedling  health,  I  have  been  able 
to  attend  but  very  irregularly,  and  I  have  felt  great  scruples  in 
continuing  to  occupy  the  chair.  Had  I  listened  to  my  own 
wishes,  I  would  have  resigned  some  time  ago,  or,  at  least,  have 
begged,  when  the  annual  election  of  the  ofl&cers  of  the  Society 
came  round,  that  a  more  efficient  President  than  myself  should 
be  chosen.  I  have  refrained,  however,  from  following  my  own 
inclinations  in  this  respect,  at  the  request  of  my  colleagues  in 
ofl&ce,  who,  in  their  kind  partiality,  have  repeatedly  expressed 
their  opinion  that  the  interests  and  welfare  of  the  Society 
would  be  best  consulted  by  my  abandoning  my  intention  of 
withdrawing  from  the  Presidential  chair.  I  candidly  confess  that 
I  have  had  less  scruples  on  this  point  since  the  election  of  our 
present  most  eflBlcient  Vice-Presidents,  Dr.  Chapman  and  Mr. 
Yeldham.  The  able  manner  in  which  they  have  presided  at 
your  meetings,  and  conducted  the  affairs  of  the  Society,  have 
left  nothing  to  be  desired ;  and  I  have  seen  with  pride  and 
satisfaction  the  ability,  eloquence,  and  practical  knowledge 
with  which  our  Vice-Presidents  have  taken  part  in  your  dis- 
cussions, and  summed  up  at  the  close  of  the  debates,  as  recorded 
in  our  Annals.  To-morrow  evening  the  election  of  the  oflBlcers 
will  come  on,  and  I  earnestly  beg  that  you  will  not,  from 
feelings  of  false  delicacy,  have  any  hesitation  in  electing  another 
President  to  succeed  me — one  who  will  more  efficiently  per- 
form the  duties  of  President  than  I  have  been  able  to  do  of  late. 

VOL.  ni.  4 


50  Address  of  the  Ptrsident. 

I  Hincf^TfAy  congratulate  you  on  the  increasing  number  of 
your  iii^rmlieTS,  and  on  the  increasing  utility  of  your  labour& 
TIj'.'  aiitiriiifitions  and  prophecies  in  which  I  indulged  on  the 
i'ii\  frl«';tion  of  our  prt'seiit  able  and  energetic  Honorary 
.S<;cr<;lary  have  l^'On  fully  fuliillwl.  15y  his  active  influence  and 
uir,y*:ixjit:(l  industiy,  the  number  of  essays  and  papers  have  so 
gnratly  increased,  that  the  Society  is  now  able  to  meet  t^'ice 
inhV:iA  of  once  every  month  in  the  session, — thus  your 
Tn';';tings  have  not  only  gained  in  number  but  in  importance 
and  usefulness,  whilst  the  publication  of  the  Annals  of  the 
Hof'/udy  are  spreading  far  and  near,  not  only  the  information 
contained  in  your  practical  and  theoretical  papers,  but  also  that 
contained  in  the  valuable  and  practical  debates  which  these 
pafy^rs  give  rise  to.  We  have  a  flattering  and  convincing  proof 
of  thi/j  in  a  letter  lately  received  from  Dr.  Meyer,  editor  of  the 
JlorruxopaihiscJie  Zeitung,  and  Physician  to  the  Leipsic  Homceo- 
pathic  Hospital,  in  which  he  says,  "  I  have  received  a  copy  of 
tlie  last  number  of  the  Annals,  and  have  already  made  arrange- 
ments to  have  one  of  the  papers  translated  and  inserted  in  my 
journal  I  will  have  much  pleasure  in  sending  you  my 
*  Jietrosj>ect  of  the  Year  1862  '  as  soon  as  it  is  published,  and 
shall  r;ertainly  make  favourable  mention  of  the  Annals  in  it 
I  have  read  the  last  number  with  great  interest,  and  am 
much  pleased  with  the  earnestness  of  the  discussions,  but 
I  lament  that  it  is  so  much  the  custom  in  your  father- 
land t^i  give  the  medicines  alternately,  consequently  making 
exa/.'t  oV;s^;rvation  very  difficult.  Could  no  means  be  adopted 
to  aUjiish  this  vicious  habit?" 

The  testimony  of  so  distinguished  and  learned  a  physician  to 
the  utility  of  the  Annals,  and  your  discussions,  cannot  fail  to  be 
gratifying  to  you.  I  have  so  often  endeavoured  to  impress  upon 
you  my  opinion  of  the  erroneous  practice  of  alternating  medi- 
cin<;s  in  quick  succession,  before  the  sphere  of  action  of  any  of 
them  can  have  terminated;  and  I  have  so  often  tried  to  inculcate 
the  a/lvantagc  of  more  simplicity  of  practice  and  a  stricter 


Address  of  the  President.  51 

adhesion  to  the  principles  handed  down  to  us  by  Hahnemann, 
that  it  is  not  necessary  for  me  now  to  say  more  than  that  I 
thoroughly  agree  with  Dr.  Meyer,  and  heartily  reiterate  his 
wish  to  see  this  practice  abolished  in  England. 

With  regard  to  the  papers  read  before  the  Society,  I  strongly 
recommend  to  the  serious  consideration  of  those  members  who 
may  hereafter  write  papers,  to  send  a  resfwrn^  of  them  a  fortnight 
before  they  are  to  be  read — ^to  lie  on  the  library  table,  to  be 
perused  by  their  fellow-members,  before  they  are  discussed.  I 
am  certain  that  the  debates  will,  in  consequence,  increase  in  in- 
terest and  in  importance,  and  reflect  more  honour  on  the  gentle- 
men who  take  part  in  the  discussions.  In  the  early  days  of  the 
Society,  two  copies  of  every  paper  were  made  and  circulated  among 
the  members  during  the  fortnight  preceding  each  meeting.  The 
result  was  most  satisfactory  with  respect  to  the  tone,  character,  and 
value  of  the  debates.  With  these  preliminary  remarks  I  shall 
now,  with  your  permission,  proceed  to  notice  the  papers  and 
discussions  of  the  session  just  closed.  From  the  cause  stated 
above,  I  am  sorry  to  say  I  was  not  able  to  attend  many  of  the 
meetings  and  join  in  the  debates. 

The  session  began  in  October,  with  a  paper  by  Mr.  Brisley, 
entitled  "  On  the  Advantages  of  Alternating  the  Higher 
and  Lower  Atteniiaiions  of  Medicines  in  the  Treatment  of  Causes 
of  Chronic  Disease*' — a  most  praiseworthy  endeavour  to  im- 
press upon  the  attention  of  the  Society  one  of  the  principles 
laid  down  by  Hahnemann,  but  too  often  forgotten  now — that 
we  should  be  extremely  careful  in  the  selection  of  our  reme- 
dies when  we  commence  the  treatment  of  any  chronic  case ; 
and  that  after  we  have  made  our  selection,  we  should  not 
capriciously  give  up  one  remedy  for  a  new  one,  until,  at  least, 
we  had  satisfied  ourselves  that  the  medicine  of  our  choice  had 
no  beneficial  action  in  the  case,  either  in  a  high,  a  moderate,  or  a 
low  dilution.  It  also  illustrated  an  important  fact  which  I 
have  repeatedly  mentioned  here — ^that  if  we  wish  a  medicine  to 
act  beneficially,  and  for  a  long  time,  we  shall  often  act  wisely 

4* 


52  Address  of  the  President. 

to  prescribe  it  in  various  attenuations,  ninning  the  gamuts  as  it 
\^'cre,  from  the  lower  to  the  higher  attenuations,  and  again 
reversing  the  order  from  the  higher  to  the  lower,  so  as  to  afford 
the  organism  a  choice,  so  to  speak,  of  every  modification  of  the 
medicinal  substance  prescribed,  and  not  pall  its  appetite  by  the 
constant  repetition  of  it  in  the  same  strength  and  dose. 

Dr.  Drury  followed  with  an  interesting  paper  upon  some 
cases  of  sudden  and  alarming  illness,  which  might,  in  certain 
circumstances,  have  given  rise  to  suspicions  of  poisoning.  The 
subject  was,  and  is,  one  of  great  imi)ortance  in  the  face  of  the 
startling  evidence  given  by  a  great  medico-legal  authority  of 
the  great  number  of  cases  of  poisoning  which  are  undetected. 
It  would  be  well  if,  following  the  example  of  Dr.  Drury,  a  care- 
ful record  were  made  of  all  the  cases  of  sudden  death  which 
occur  in  the  hands  of  every  practitioner.  We  should  do  some- 
thing to  allay  the  unwise  panic,  and  often  unjust  suspicions^ 
when  such  an  event  takes  place ;  and  by  a  careful  investigation 
of  the  causes  of  such  dreadful  catastrophes,  we  might  do  some- 
thing to  avert  some  of  them. 

The  next  paper  was  by  Mr.  Harmer  Smith,  "  Upon  the  JEm- 
ployment  of  AvjxUiaries " — ^an  attempt  to  lay  down  certain 
general  rules  for  the  guidance  of  practitioners.  As  this  subject 
was  also  incidentally  handled  by  Dr.  Hilbers,  I  will  reserve 
any  observations  which  suggest  themselves  till  I  notice  his 
paper. 

I  have  now  to  record  a  most  interesting  paper  **0n  the  Treat- 
ment of  Ovarian  Tvmou/rs,'*  by  Mr.  Leadam.  Although  the 
title  was  thus  general,  the  paper  was  apropos  of  a  case  of 
ovariotomy.  The  operation  was  performed  with  great  skill  and 
steadfast  coolness  by  Mr.  Ayerst,  and  after  the  life  of  the 
poor  woman  had  been  several  times  despaired  of,  in  conse- 
quence of  the  violence  of  the  enteritic  symptoms,  she  even- 
*  tually  recovered.  This  case  is  very  instructive,  both  in  the 
way  of  warning  and  encouragement,  and  it  is  highly  satis- 
factory to  find  the  uniform  and  universal    testimony  of  aU 


Address  of  the  President.  53 

who  have  had  opportunities  of  obBenration,  to  the  skill  and 
success  of  Mr.  Ayerst  as  an  operating  suigeon.  We  are  now 
no  longer  dependent  upon  the  caprice  of  the  suigeons  of  the 
old  school,  and,  as  they  have  thought  proper  to  turn  their  backs 
upon  us,  they  cannot  be  surprised  if  we  should  now,  and  in 
future,  content  ourselves  with  such  aid  as  is  obtainable  in  the 
increasing  experience,  skill,  and  dexterity  in  operating,  of  mem- 
bers of  our  own  body. 

Mr.  Leadam's  practical  and  instructive  paper  was  followed 
by  one  of  a  more  ambitious  character,  from  the  pen  of  Dr. 
McGilchrist,  of  Edinburgh,  entitled,  "  Is  DipMheria  a  Specific 
Disease  i  '*  It  is  evident  that  the  writer  of  this  essay  has  been 
long  trained  in  the  art  of  composition.  It  has  the  merits  and, 
perhaps,  some  of  the  demerits  of  a  merely  literaiy  articla  It 
is  ingenious  and  erudite,  but  the  arguments  and  illustrations 
bear  a  larger  proportion  to  the  positive  observations  than  is 
usual  in  a  paper  submitted  to  our  body  upon  so  intensely 
practical  a  subject  as  diphtheria.  However,  such  well-written 
essays  have  a  use  of  their  own  kind,  and  it  is  weU  for  us  that 
in  our  body  we  have  so  great  an  infusion  of  literature. 

Dr.  Ozanne,  of  Guernsey,  followed  with  a  paper  "  Upon  some 
Cases  of  OphtJialmia"  As  he  sent  it  merely  to  stop  a  gap 
at  a  former  meeting,  and  as  he  was  then  prevented  firom  com- 
pleting in  time  the  essay  which  is  to  be  read  to-night,  and  of 
which  the  account  of  the  cases  I  have  alluded  to  evidently 
forms  a  part,  it  would  be  premature,  nay,  unfair,  to  make  any 
observations  upon  it  beyond  the  obvious  one,  to  all  present, 
that  it  is  sure  to  be  replete  with  practical  information,  and  give 
evidence  of  careful  investigation. 

The  next  paper,  or  rather  communication,  was  by  Mr.  Daniel 
Smith,  in  which  is  narrated  an  interesting  case  of  fever,  which, 
although  at  one  time  it  appeared  likely  to  have  proved  fatal, 
by  the  judicious  treatment  it  received,  eventually  recovered. 
It  is  encouraging  to  young  practitioners  who  may  be  disposed 
to  despair  of  the  recovery  of  their  patients  in  apparently  des- 
perate cases. 


54  AilJnss  of  the  President. 

In  the  same  month,  Dr.  Marston.  of  Devizes,  read  his  elabo- 
nitr  rssay,  "  On  the  Phi/8iolt}ffy  ami  Patholoffy  of  the  Ganr 
I// inn  if  St/sfnn  of  Xirrvs,  dnusidered  in  Especial  Melattan  to 
IlnttHi'fpfffhic  ThrajKuticny  It  is  well  that  we  should  have 
sue  h  sulijrcts  ])rou;:ht  belore  us  from  time  to  tima  There  is, 
un<l<)ul)tc(lh%  a  ri»k  of  our  becoming  so  absorbed  in  the  en- 
gi-ossiiig  details  of  the  ]^ractico  of  IIomaK)pathy  as  to  n^- 
Icct  vi«*wing  the  general  therapeutic  law,  which  guides  us  in 
its  i-cliitiou  to  the  constantly  iluctuating  and  frequently  ad- 
vamiiig  sciences  of  physiohjgy  and  pathology  with  wliich  it  is 
intimately  connecteil  If,  however,  we  were  to  shape  our  practice, 
nut  upon  the  well-established  observations  recorded  in  the  works 
of  Hahnemann  and  others  who  have  assisted  him  in  ascertaining 
the  positive  pathogenetic,  and  therefore  curative  efiTects,  of  medi- 
cines, but  upon  the  speculations  of  physiologists  and  patholo- 
gists, wc  should  very  soon  find  that  we  had  returned  into  the 
delusions  from  which  Hahnemann's  genius  and  industry  had  de- 
livered us.  That  a  know^ledge  of  pathology  may  be,  and  is,  of 
the  greatest  advantage  to  the  practitioner  of  homoeopathy,  is 
almost  a  self-evident  proposition,  and  the  successful  and  bril- 
liant career  of  those  who  have  been  celebrated  pathologists 
among  us  is  an  illustration  of  the  fact,  if  it  require  illustration ; 
but  it  is  one  thing  to  enlighten  our  Homoeopathic  practice  by 
a  profound  pathology,  and  quite  another  thing  to  attempt  to 
build  up  a  wholly  new  system  of  practice  on  the  assimiption  of 
the  truth  of  novelties.  I,  for  one,  feel  myseK  called  upon  to  dis- 
claim any  participation  in  such  innovations,  or  approval  of  the 
novel  and  immature  system  of  practice  arising  out  of  them,  which 
is  not  only  subversive  of  the  fundamental  propositions  and  well- 
considered  plan  propounded  by  Hahnemann,  and  successfully 
followed  by  many  thousands  of  his  disciples  throughout  the 
globe,  but  fraught  with  danger  to  Homoeopathy  as  a  practical 
art,  by  substituting  pathological  conjecture  for  the  well -ascer- 
tained facts,  the  result  of  oft-repeated  experiments,  both  patho- 
genetic and  clinical,  extending  over  a  long  series  of  years.  Let 
inc  not  be  misunderstood.    I  am  quite  alive  to  the  great  advan- 


Address  of  the  President,  55 

tage  of  a  sound  application  of  physiology  and  pathology  to 
assist  the  Homoeopathic  practitioner  in  forming  a  correct  diag- 
nosis of  disease,  and,  in  common  with  the  Society,  I  shall 
always  hail  with  satisfaction  all  well-directed  efforts  which 
have  for  their  object  the  development  of  Homoeopathy  and  the 
improvement  of  our  knowledge  of  the  action  of  medicines,  and 
of  the  indications  for  their  judicious  employment  in  any  given 
case;  but  it  is  only  by  long  and  persevering  inquiry,  oft- 
repeated  and  careful  experiments,  and  patient  investigation,  free 
from  all  bias  or  predilection  for  preconceived  theories,  that  a 
claim  to  serious  attention  can  be  admitted  when  the  doctrines 
and  practice  taught  to  us  by  Hahnemann  are  sought  to  be 
departed  from  and  overturned. 

The  paper  "  On  Local  Anaesthesia,"  by  Dr.  Cronin,  jun.,  has 
the  merit  of  being  a  short  and  dear  statement  of  his  own 
observations  and  experiments  upon  a  subject  of  considerable 
and  increasing  importance ;  and  it  is  desirable  that  he  should 
continue  his  experiments  and  observations,  as  they  cannot  fail 
to  increase  in  interest,  and  probably  be  of  assistance  to  us  in 
alleviating  the  sufferings  of  our  patients  in  cases  attended  with 
acute  pains. 

Dr.  Cockbum,  of  Glasgow,  next  read  his  essay,  or  rather 
treatise — for  even,  in  an  abridged  form,  it  deserves  from  its  great 
length  the  latter  appellation — entitled,  "  7s  the  Doctrine  of  Infini- 
tesimals Consistent  with  Reason  and  Experience  t "  This  ques- 
tion he  takes  upon  himseK  to  answer  in  the  negative.  Nothing 
can  better  demonstrate  the  liberty  of  speech  we  accord  to  our 
members,  than  the  attentive  hearing  accorded  to  the  reading  of  a 
paper,  the  tendency  of  which  is  to  overthrow  the  whole  system 
of  practice  to  which  our  lives  have  been  devoted.  The  paper  has 
many  good  qualities ;  it  is  a  work  of  mind ;  the  author  has  be- 
stowed much  labour  upon  it,  and  prepared  it  with  great  care.  Had 
he  given  as  much  attention  to  facts  as  he  did  to  arguments,  he 
would,  in  all  probability,  never  have  written  it.  It  is  evidently 
the  production  of  a  physician  who  is  isolated ;  who  has  little 


5<)  Ailtinss  of  the  Vrfmihnt. 

iiii;iii<  nf  rniniiiiiniiatioii,  little  interchange  of  opinions,  with 
lii>  t«  Il«i\v-|iiii(titiniitr3;  anJ  ft*\v,  if  any,  op{)ortunities  of  seeing 
aii'l  watrhiiiLj  the  nsiilts  of  the  practice  of  men  of  far  longer 
(xjM  li.  II. f  than  hiiiisilf  in  Ilnnidopathy.  Hence  the  narrow 
<  in  1..  ill  whirh  his  \'w\\A  of  tlie  action  of  minute  doses  of  medi- 
( iiif  IIP-  (iiiitiiuil ;  an<l  \w.  <h»e.s  not  i>erceive  that  the  circum- 
scrilM-.l  n|iiuinns  cntrrtain^Ml  hy  liim  are  at  variance  with  expe- 
ri<iM«',  aii'l  that  th<*  puhlic-ation  of  thcni  cuts  the  very  ground  from 
un«l<  r  liis  f»M-t,  uj»ou  which  an*  founcU'd  the  facts  which  led  to 
his  rnii version  ;  for  IIoniM-opathy  spivad  all  over  the  Continent, 
ami  i»i«'nc«l  into  Ch-cai  ]»ritain,  and  diffused  itself  all  over  Ame- 
ri<  a  hy  the  very  infinitesimal  dose.s,  the  belief  in  the  efl&cieneyof 
wliicli,  ]\(\  states,  is  inconsistent  witli  reason  and  experienca  The 
author  must  liave  felt,  as  the  discussion  proceeded  which  arose 
after  the  reading  of  his  paper,  how  even  those  who  most  opposed 
his  o])inions  still  respected  his  honesty  of  purpose.  It  is  deeply 
to  he  regretted  that  he  and  some  who  joined  in  the  debate 
have  not  shown  as  much  consideration  for  Hahnemann.  Let 
young  practitioners  remember  that  absence  of  reverence  is  no 
sign  of  greatness  of  intellect, — quite  the  reverse.  The  lower 
we  descend  in  the  scale  of  being,  the  less  of  this  quality  do  we 
find ;  and  the  more  we  ascend,  the  more  do  we  meet  with  it 
A  mouse,  an  oyster,  a  flea,  have  no  reverence  for  a  philosopher ; 
but  a  philosopher  has  a  reverence  for  a  mouse,  an  oyster,  or  a 
flea.  It  would  be  a  work  of  supererogation  for  me  to  attempt 
a  panegyric  of  Hahnemann  in  this  assembly.  His  labours  to 
increase  our  knowledge  of  medicine,  his  untiring  industry,  his 
valuable  experiments  extending  over  a  number  of  years,  his 
great  erudition,  his  genius,  are  too  indelibly  impressed  upon  us ; 
and  our  gratitude  is  too  deeply  rooted  in  our  hearts  to  require 
that  I  should  dilate  upon  his  merits. 

Let  us  examine  how  far  the  author  is  borne  out  by  facts  in 
the  statements  he  has  ventured  to  make.  Dr.  Cockbum  fixes 
the  year  1795  as  that  in  which  Hahnemann  discovered  the 
Homoeopathic  law ;   and  he  tells   us  that  his  greatest  success 


Address  of  the  President  57 

was  obtained  during  the  next  nine  years — ^that  is,  from  1795 
to  1804 ;  that  it  was  his  success  at  this  period  which  gave 
him  his  renown;  and  that  the  reason  of  this  great  success  was, 
his  giving  medicines  in  large  doses.  Let  us  see  how  the  histori- 
cal facts  square  with  this  hypothesis — for  it  is  nothing  more. 
Where  was  Hahnemann  during  these  nine  years  ?  He  spent 
them  in  the  following  places: — In  1795,  he  went  to  live  in 
the  small  town  of  Wolfenbeuttel ;  soon  after,  we  find  him  in 
another  insignificant  place — Konigslutter ;  he  remained  here  till 
1799,  that  is  four  years  only.  In  the  year  1799,  when,  accord- 
ing to  Dr.  Cockbum,  he  was  in  the  blaze  of  his  popularity  and 
reputation,  he  went  to  Hamburg,  but  he  did  not  remain  there, 
because  he  had  nothing  to  do ;  and  the  same  year  he  went  to 
Altona.  He  remained  there  for  a  very  short  time,  and  removed 
to  MoUen,  in  Lauenburg;  thence  he  went  to  Eulenburg — thence 
to  Machern — thence  to  Dessau — thence  to  Torgau,  where,  in 
the  year  1806,  or  two  years  after  the  date  assigned  by  Dr. 
Cockbum  and  those  who  endorsed  his  statement,  he  published 
his  first  sketch  of  the  Homoeopathic  system — "  The  Medicine  of 
Experience^'  in  an  Allopathic  Journal  So  that  in  these  nine 
years,  when  his  success,  according  to  Dr.  Cockbum,  made  him 
so  popular,  he  had  lived  in  nine  different  places,  most  of  them 
utterly  insignificant ! 

Let  us  now  see  how  far  Hahnemann's  own  testimony  and 
practice  contradicts  the  extraordinary  statements  respecting  him 
made  by  the  author  of  the  paper. 

Dr.  Stapf  was  one  of  his  most  intimate  friends  and  earliest 
disciples.  The  letters  Hahnemann  wrote  him  were  strictly 
confidential.  In  some  of  these  he  directs  Stapf  how  to  treat  his 
daughter,  about  whom  he  was  very  anxious,  and  of  whom 
Hahnemann  was  evidently  very  fond.  Can  we  have  a  greater 
test  of  Hahnemann's  sincerity  than  shown  in  the  tenour  of  these 
directions?  Does  he  recommend  massive  doses,  frequently 
repeated?  (see  p.  75  of  No.  VII.,  March,  1862,  of  Annals)  : — 
"  It  seems  to  be  doing  well  now  with  your  dear  daughter,  yet 


58  A  tidress  of  the  PrendetU, 

it  will  In3  nccossary  that  tlie  Phosphorus  should  be  allowed 
to  continue  its  ofTcct  for  sixt(»on  or  eighteen  days."  This  is 
in  Si'|)tt'nil>or,  1827.  In  .January,  1829,  he  writes  (see 
]).  140  of  Annals) : — "  Altliou^li  the  winter  is  unfavourable  to 
an  anti])soric  courso,  yet  I  tliink  ]Miss  Eliza  will  continue  to 
inij)rove.  You  have  given  her  a  dose  of  Nux  Vomica;  but 
should  the  next  catanieuial  ])eriod  occur  at  the  right  time,  you 
may  pr«;teniiit  the  dose.  You  may,  however,  give  her  the  dose 
of  Zincum  on  the  20th  or  21st  of  January  with  confidence; 
afterwards  we  shall  see  what  is  to  he  done." 

His  practice  was  strictly  in  accordance  with  his  precepts  as 
given  in  the  Organon :  to  select  a  medicine  with  the  utmost 
care — to  give  one  dose,  generally  of  the  30th  dilution,  par- 
ticularly when  prescribing  any  of  tlie  heroic  medicines,  and  not 
to  repeat  it  till  it  had  exhausted  its  effect,  or  to  dilute  it  with 
water  and  distribute  the  dose  in  spoonfuls  over  a  given  number 
of  hours,  days,  and  sometimes  weeks.  He  published  no  cases 
after  he  had  thoroughly  made  known  his  system,  except  three 
in  the  Preface  to  one  of  the  volumes  of  his  Materia  Medica 
Pura,  and  these  cases  only  for  the  purpose  of  illustrating  his 
method  of  selecting  his  remedies.  His  answer  to  Fleischmann 
is  worthy  of  record  here,  as  exemplifying  the  mode  in  which  a 
case  ought  to  be  studied,  and  the  appropriate  remedy  chosen. 
Fleischmann,  when  yet  an  imbeliever  in  Homoeopathy,  suffered 
from  sciatica,  and  having  exhausted  all  the  ordinary  measures  for 
obtaining  relief  in  vain,  wrote  a  statement  of  his  case  to  Hahne- 
mann, who  replied  to  this  effect: — "If  you  study  the  symptoms 
of  such  and  such  medicines  as  given  in  my  Materia  Medica^ 
you  will  find  what  will  enable  you  not  only  to  cure  yourseU^ 
but  others  also."  Fleischmann  did  as  directed,  discovered  the 
remedy  for  his  sciatica,  and  convinced  himself  of  the  truth  of 
Homoeopathy,  and  of  the  trustworthiness  of  Hahnemann's 
provings. 

The  actual  time  of  Hahnemann's  European  celebrity  did  not 


Address  of  the  President.  59 

really  commence  till  after  the  year  1810,  when  he  had  pub- 
lished the  first  edition  of  his  Oiganon ;  it  went  on  increasing 
until  1843,  when  he  died.  He  never  went  back  to  laige  doses. 
To  this  fact  I  myself  can  vouch.  I  first  studied  under  Hahne- 
mann in  1826,  at  Coethen — I  again  went  to  him  in  1828,  and 
again  in  1831,  still  at  Coethen.  When  he  removed  to  France  in 
1834,  I  went  there  to  meet  him,  and  was  present  at  the  Great 
Congress  of  Homoeopathic  Physicians  assembled  in  Paris  to  do 
him  honour,  and  to  welcome  him  to  France ;  and  I  repeatedly 
went  over  to  Paris  to  see  him  during  the  remaining  years  of  his 
life.  During  these  years,  besides  the  many  instructive  con- 
versations I  had  with  him,  I  had  frequent  consultations,  both 
verbal  and  by  letter,  on  many  cases  of  interest  or  of  danger, 
and  I  can  bear  testimony  to  his  consistent  advocacy  for 
the  emplojTuent  of  infinitesimal  doses,  and  to  the  eminent 
success  which  attended  his  treatment  of  the  most  complicated 
and  serious  diseases  occurring  in  individuals  of  every  nation  and 
of  every  clime.  During  the  latter  years  of  Hahnemann's  sojourn 
in  Paris,  our  colleague,  Mr.  Hugh  Cameron,  had  similar  and 
frequent  opportunities  of  conversing  and  consulting  in  some 
most  serious  cases  with  Hahnemann,  and  he  will  vouch  for  the 
foregoing  facts,  and  bear  similar  testimony  to  me  respecting  the 
opinions,  practice,  and  great  success  of  Hahnemann's  treat- 
ment. 

It  is  with  wonder,  sorrow,  and  astonishment,  not  unmixed 
with  indignation,  that  we,  who  had  the  honour  and  advantage 
of  repeated  and  intimate  communications  with  our  great  master, 
and  who  listened  with  grateful  reverence  to  the  words  of 
wisdom  and  valuable  practical  precepts  that  dropped  from  his 
lips,  read  and  hear  the  terms  in  which  some  who  give  them- 
selves out  as  his  followers,  permit  themselves  to  speak  of  this 
great  and  good  man,  and  unblushingly  draw  upon  their  imagi- 
nations in  giving  utterance  to  the  most  erroneous  and  fabulous 
accounts  of  his  opinions  and  actions,  showing  an  incredible 
ignorance  of  the  maxims  and  truths  contained  in  his  works^ 


60  Address  of  the  Presideni. 

of  his  conduct  throughout  his  long  and  honourable  career,  and 
an  iiTcvereuce  for  the  genius,  the  enidition,  and  the  unwearied 
industry  which  enabled  him  to  create  and  establish  the  system 
of  medicine  by  which  they  gain  their  livelihood  and  hope  to  rise 
to  fame  and  fortune.  One  knows  not  which  to  admire  most,  the 
ingratitude  or  the  presumption  of  such  soi-disant  disciples  of 
Ilahuciiiann.  However,  this  mode  of  the  young  to  be  pre- 
sumptuous  and  to  ignore  the  wisdom  and  knowledge  of  their 
superiors  is  of  all  time.  Pliny  the  younger  records  of  the 
youth  of  his  day — "  Barum  hoc  in  adolescentibus  nostris,  nam 
quotusquisque  vel  aetati  alterius  vel  auctoritate  ut  minor,  cedit/ 
Statim  sapiunt ;  Statim  sciimt  omnia ;  neminem  verentur;  imi- 
tantur  neminem;  atque  ipsi  sibi  exempla  sunt !" 

Dr.  Cockbum  builds  a  somewhfit  ingenious  argument,  already 
often  put  forward  in  Germany  and  France  by  our  AUopathic 
opponents,  against  the  use  of  infinitesimal  doses,  upon  the 
assumption  that  in  the  course  of  repeated  triturations  the 
original  medicinal  matter  will  be  entirely  lost  in  some  portion 
of  the  preparation,  fix)m  the  impossibility  of  effecting  a  suffi- 
ciently fine  subdivision  of  its  particles.  It  is  plain,  although 
strange,  that  he  has  never  read  Dr.  Samuel  Brown's  admirable 
essay  on  the  theory  of  small  doses.  It  is  equally  strange,  that 
in  the  debate  which  followed  the  reading  of  Dr.  Cockbum's 
paper,  one  of  the  speakers  has  reiterated  the  interrogation — 
"  Why  should  we  use  the  6th  dilution,  when  the  spectrum 
analysis  shows  the  substance  only  as  far  as  the  5th  ?  Why  not 
stop  at  the  point  where  we  know  medicine  to  be  ? "  It  is  sur- 
prising that  it  did  not  occur  to  the  questioner,  in  answer  to  his 
query,  that  the  spectrum  analysis,  which  only  discovered 
matter  in  the  5th  dilution  the  other  day,  simply  verified  the 
previous  observation  made  by  means  of  Homoeopathy,  that  the 
vital  test  is  far  superior  to  any  chemical  one.  In  the  essay  on 
the  theory  of  small  doses,  above  alluded  to.  Dr.  Brown  says: — 
"  The  numerous  able  works  asserting  the  utility  of  Homoeopa- 
thic practice,  on  the  ground  of  sheer  experience  among  the  sick. 


Address  of  the  President.  61 

are  calculated  to  impress  their  opponents  with  the  conviction 
that  there  is  certainly  enongh  of  practical  truth  in  the  prin- 
ciple to  authorise  them  to  give  it  a  candid  trial,  since  so  many 
of  their  equals,  in  whatever  is  scientific  and  virtuous,  are 
ready  to  stand  by  both  the  principle  and  the  practice.  Let 
them  take  the  fact  of  the  number  and  merit  of  Homoeopathic 
physicians  and  books  as  their  certificate  of  right  to  make  ex- 
periments upon  their  patients,  especially  since  it  will  only  be 
doing  nothing  at  the  very  worst,  and,  still  more  especially,  as 
they  are  well  used  to  the  art  of  prosecuting  experimental  inves- 
tigations of  a  far  more  formidable  kind,  in  connexion  with  the 
custom  of  exhibiting  sensible  doses  of  the  most  potent  and 
untried  of  chemicals.  Such  is  one  view  of  the  question ;  but 
still  a  theory  of  small  doses  is  the  desideratum. 

The  Professor  of  Mathematics  at  Prague  has  endeavoured  to 
supply  this  want  according  to  his  habits  of  thought,  his  ability, 
and  his  means.  Professor  Doppler  is  not  a  physician,  nor 
yet  a  Homoeopathic  partisan,  but  simply  brings  the  light  of  a 
certain  physical  distinction  to  bear  on  the  question  at  issue, 
being  ready  neither  to  oppose  the  prevailing  school  of  medicine, 
nor  to  abet  the  followers  of  Hahnemann,  but,  having  been  dis- 
turbed, and  probably  vexed,  by  the  noise  of  the  imcharitable 
fight  around  him,  being  willing  to  say  whatever  his  own  com- 
mimication  with  science,  elsewhere  than  in  medicine,  might 

enable  him  to  advance  to  the  point The  gist 

of  the  argmnent  he  leads  out  is  to  the  effect,  that  the  question 
of  greatness,  respecting  material  operations,  is  altogether  relative 
to  the  kind  of  operations  investigated.  The  quantity  of  caloric 
in  the  whole  world,  if  it  were  expressed,  and  could  be  condensed 
by  some  Farraday  or  Thilorier  on  a  scale  of  the  most  deli- 
cate of  balances,  would  not  make  it  kick  the  beam  so  sensibly 
as  the  thinnest  breath  of  air — ^if  at  all ;  yet,  that  latent  heat 
is  so  magnificent  in  power,  that  certain  local  disturbances  of  its 
equilibrium  are  productive  of  earthquakes  and  volcanoes ;  and 
Newton  used  to  boast,  with  that  quick  pleasantry  of  illustration 


C2  Afifirfss  of  the  PrrMeni. 

which  was  or  chnractoristic  of  him  as  his  sure  induction,  that 
if  he  were  the  master  of  fire,  he  could  pock  tho  planet  in  a 
nutshell.  Electricity,  too,  is  said  to  l>o  imponderable;  but  tho 
siulrlen  ivstoration  of  the  iiit<?rrui)ted  balance  between  such 
quantities  of  tho  subtle  thiid  as  an*  contained  in  opposing 
clouds,  theiiisclves  so  diniiuutive  in  cum]iarison  with  the  body 
of  tho  oailli,  is  the  cause  of  thunderstorm.  Nothing  created  is 
great  or  little,  excojjt  comparatively,  and  in  relation  to  its  effects 
and  the  methoil  of  oi>eration.  Hence,  there  may  arise  on  the 
very  threshold  of  the  inquiry,  the  preliminary  question,  whe- 
ther a  medicine  acts  on  the  frame  by  virtue  of  its  ponderable 
quantity,  or  by  the  extent  of  its  surface  wliich  is  brought  in 
contact  with  the  surfaces  of  the  structures  on  which  it  re-acts  ? 
This  query  must  be  ultimately  answered  by  the  extensive  obser- 
vation of  physicians  seeking  a  reply  to  it ;  but  to  the  physicist 
it  is  plain,  that  if  the  latter  be  the  true  rationale  of  the  opera- 
tion of  medicines  (so  far  as  that  is  physical),  the  Homoeopathist 
prescribing  the  deciUionths  of  grains  may,  after  all,  be  giving 
greater  doses  in  reality  than  the  Allopathist  when  he  exhibits 
his  ounces.  So  reasons  Doppler ;  and  distinguishing  that  phy- 
sical superficies  of  a  body  which  is  the  simi  of  the  exposed 
surfaces  of  its  exposed  particles,  he  shows  that  the  triturations 
practised  by  the  Homoeopathic  pharmaceutist  increase  the  latter 
surface — that  is,  the  surface  that  shall  be  brought  into  reaction 
with  the  tissues — at  a  very  rapid  rate.  A  cubic  inch  of  brim- 
stone broken  into  a  million  of  equal  pieces,  a  sand  grain  each 
in  size,  is  magnified  in  sensible  surface  from  six  square  inches 
to  more  than  six  square  feet.  It  is  calculated  in  this  way 
that,  if  each  trituration  of  the  Homoeopathist  diminish  his  drug 
a  hundred  times  (an  extremely  moderate  allowance,  I  aver), 
the  sensible  surface  of  a  single  inch  of  sulphur,  or  any  other 
drug,  shall  be  two  square  miles  at  the  third  trituration ;  the 
size  of  all  Austria  at  the  fifth ;  of  Asia  and  Africa  together  at 
the  sixth ;  and  of  the  sun,  with  all  his  planets  and  their  satel- 
lites— at  the  thousandth  ?     No,  but  at  the  ninth  ! 


Address  of  the  President.  63 

The  method  of  trituration  is  very  simple.  A  grain  of  the 
drug  to  be  prepared  is  carefullj  rubbed  down  in  99  grains  of 
soluble,  insipid,  and  pure  sugar  of  milk,  which  is  extensively 
made  in  Switzerland  from  the  residuary  whey  produced  in  the 
manufacture  of  cheese;  a  grain  out  of  this  100  is  triturated 
with  other  99  of  the  sugar  of  milk ;  a  grain  of  this  mixture  of 
the  second  dilution  is,  in  its  turn,  diflfused  through  99  grains  of 
fresh  sugar,  so  as  to  produce  the  third  dilution ;  and  so  on  to 
the  thirtieth,  or  beyond  it. 

In  connexion  with  the  trituration  of  insoluble  solids,  it  has 
been  objected,  that  if,  for  example,  a  million  of  separate  parti- 
cles be  contained  in  a  grain  of  the  third  trituration,  and  that 
trituration  be  then  diffused  through  100  drops  of  pure  water, 
each  drop  wiU  contain  10,000  particles;  that  one  of  these 
drops,  diffused  in  100  of  pure  water,  will  give  100  particles 
in  each  drop;  that  the  next  dilution  will  yield  only  one 
particle  for  each  drop ;  that  consequently,  in  the  next  grain 
there  must  be  999  drops  of  water  without  a  single  particle  of 
the  original  metal,  or  other  insoluble  body;  and  that,  in  fine, 
the  higher  dilutions  of  the  Homoeopathic  practitioner  are 
hereby  for  ever  demonstrated  to  be  null  and  void,  at  least  in 
the  case  of  insoluble  substances.  This  looks  very  shrewd, 
and  even  heis  an  air  of  the  recondite  about  it.  But  who 
assured  the  sagacious  amateur  that  the  ^ects  of  trituration,  in 
the  way  of  diffusion,  though  indefinitely  inferior  to  those  of 
true  solution,  are  to  be  calculated  by  petty  millions  of  particles  ? 
Besides,  there  is  every  probability  that  the  diffusion  through 
the  milk-sugar  is,  at  a  certain  point,  consummated  to  the  degree 
of  solution  itself  by  chemical  reaction  throughout  the  mass. 
Molten  iron  solidified  has  no  action  whatever  on  dry  air,  and 
even  when  subdivided  by  filing,  does  not  oxidate  itself,  without 
the  disponent  help  of  water  and  carbonic  acid ;  but  let  it  be 
reduced  from  the  state  of  hydrated  peroxide  by  hydrogen,  at  a 
temperature  not  far  above  the  boiling  point  of  water,  and  no 
sooner  is  it  shaken  out  of  the  apparatus  in  which  the  opera-. 


04  A  tf dress  of  the  President. 

tioii  has  hoon  conducted,  than  it  bursts  into  combustion.  All 
h()(li«s  can  unite  chemically  with  each  other,  if  the  proper  cir- 
oumstaiicps  he  alForded  them;  and  all  solid  bodies  must  sufiTer 
mutual  reaction,  if  j»ivscnti*d  to  one  another  in  fine  enough 
(livisinn.  This  is  exactly  the*  case  in  the  instance  under  notice. 
The  insoluble  hocly — say  the  metal — unites  chemically  with 
the  su^ar,  becomes  everywhere  diffused  in  a  degree  of  division 
far  rcMnoved  beyond  computation  by  numbers,  and  the  sac- 
charine; com])ound,  probably  still  insoluble  in  the  true  sense  of 
tli(;  tc^ni,  rapidly  passes  through  the  closest  filter,  and  remains 
sus])en(led  invisibly  among  the  particles  of  the  solution.  This 
is  surely  tlie  reverse  of  incredible  to  the  chemical  analyst. 
In  a  word,  let  such  dilettanti  as  found  objections  on  their  own 
limitation  of  mechanical  subdivision,  and  on  their  own  in- 
ade([uate  conception  of  the  nature  of  particles,  remember  the 
rigorous  calculation  of  an  eminent  astronomer  of  their  own  day, 
that  Encke's  comet,  vast  and  wide-spreading  as  it  sweeps 
through  the  firmament,  is  composed  of  an  air  so  attenuated, 
that  if,  by  some  transcending  force,  it  were  compressed  to  the 
density  of  our  atmosphere,  it  might  be  folded  in  a  walnut, 
and  they  will  never  attempt  the  gratuitous  task  again." 

The  next  paper  is  a  valuable  one,  although  rather  desultory, 
by  Dr.  Hilbers,  of  Brighton,  entitled  "  Ohservations  on  some 
Qitestiom  of  Medical  Ethics,  with  Special  Reference  to  so- 
called  Homoeopathic  Practitioners^  It  is  written  in  a  liberal 
spirit,  and  contains  much  practical  matter,  interspersed  with 
some  excellent  advice  to  younger  practitioners,  which  they  will 
do  well  to  follow.  With  respect  to  the  employment  of  auxiliaries, 
so  frankly  dealt  with  by  Dr.  Hilbers,  which  was  the  subject  of 
Mr.  Harmer  Smith's  paper,  I  am  decidedly  of  opinion  that  it  is 
impossible  to  attempt  to  lay  down  rules  for  their  use.  Their  em- 
ployment must  ever  be  exceptional.  It  is  a  matter  to  be  left  to 
the  conscience  of  the  practitioner,  and  to  his  sense  of  duty  to 
his  patient — dependent  on  his  consciousness  of  his  own  want  of 
knowledge  of  the  powers  of  Homoeopathic  remedies,  and  his 


Address  of  the  President.  66 

inexperience  how  to  select  them  in  exceptional  cases,  not  only 
in  the  cure,  but  in  the  palliation  of  disease,  when  the  amount 
of  pain  or  suffering  is  such  as  to  cause  the  patient,  his  friends 
and  physician,  to  desire  more  immediate  relief  than  the  pro- 
gress of  treatment  strictly  curative  [which  aims  more  at  ulti- 
mate results  than  at  immediate  effects]  will  admit  of— ^iependent 
sometimes  upon  the  previous  habits  superinduced  in  the  organ- 
ism by  the  past  Allopathic  treatment,  which  in  some  cases  it  is 
more  prudent  to  attempt  to  antidote,  and  in  others  safer 
gradually  to  wean  the  patient  from,  than  suddenly  to  stop- 
dependent  sometimes  upon  the  state  of  mind  and  prejudices  of 
the  patient  and  Mends,  with  respect  to  the  action  and  virtue  of 
Homoeopathic  medicines,  which  have  not  only  the  original 
disease  to  combat,  but  often  an  endless  complication  of  symp- 
toms produced  by  a  long  persistence  in  the  use  of  drugs  in 
large  doses— dependent  sometimes  upon  the  practitioner's  Allo- 
pathic experience  of  by-gone  days,  of  the  palliative  virtue  of 
means  which  will  give  temporary  relief  to  pain  or  suffering,  and 
cause  but  a  short  and  slight  interruption  to  the  curative  treat- 
ment sought  for  by  the  administration  of  Homoeopathic  reme- 
dies. It  would  be  utterly  useless  to  seek  to  establish  a  prin- 
ciple to  guide  us  in  such  exceptional  cases. 

My  experience  fully  bears  out  the  opinions  expressed  by 
Dr.  Hilbers,  that  the  tendency  to  the  employment  of  auxilia- 
ries exists  more  in  the  practice  of  those  practitioners  who 
give  large  doses  of  medicines,  often  in  the  more  crude  and 
material  form,  than  in  those  who  habitually  prescribe  infini- 
tesimal doses.  I  have  perhaps  better  and  more  frequent 
opportunities  than  most  other  Homoeopathic  physicians  of 
forming  a  correct  judgment  upon  this  point.  From  the  fact 
of  my  name  having  been  longest  before  the  public  as  con- 
nected with  Homoeopathy,  and  from  my  age^  and  position  as 
consulting  physician,  many  cases  are  brought  to  me  which  have 
previously  been  under  other  Homoeopathic  practitioners  and  in 
the  history  of  the  cases  and  detail  of  the  past  treatment  given 

VOL.  m.  5 


6  6  Address  of  the  President. 

to  mo,  I  have  almost  invariably  found  that  the  resoit  to  auxi- 
liaries has  been  much  more  frequent  in  the  treatment  pursued 
by  those  practitioners  who  are  in  the  habit  of  prescribing  large 
doses.  I  have  also  almost  invariably  observed  that  as  each 
Iloiuoeopathic  practitioner  has  gained  more  experience  of  the 
powers  of  homoeopathic  medicines,  he  has  abandoned  the  larger 
doses,  and  approached  nearer  to  the  practice  of  Hahnemann  and 
his  earlier  disciples  in  prescribing  infinitesimal  doses ;  and  I  can 
confidently  affirm,  from  all  I  have  observed,  that  increased  suc- 
cess in  the  treatment  of  their  cases  has  attended  upon  the  changa 

With  respect  to  the  point  so  creditably  and  liberally  treated 
by  Dr.  Hilbers,  of  what  ought  to  be  our  demeanour  and  con- 
duct to  our  medical  opponents  of  the  prevailing  school,  I  have 
so  often  expressed  my  sentiments  in  former  addresses  delivered 
from  the  chair,  and  in  our  debates,  that  it  is  unnecessary  for 
me  to  do  more  than  reiterate  my  advice  that  we  should  never 
imitate  them  in  their  iUiberality,  dogmatism,  and  uncharitable- 
ness.  It  is  gratifying  to  reflect  that  some  of  the  most  distin- 
guished amongst  our  Allopathic  fraternity  are  above  the  petty 
considerations,  the  pusillanimity,  and  the  bigotry,  that  have 
influenced  many  of  their  own  body,  to  their  own  loss  much 
more  than  to  ours.  But  in  nothing  do  I  agree  with  Dr.  Hilbers 
more  than  in  his  opinion  with  respect  to  what  should  be  the  con- 
duct of  Homoeopathic  practitioners  towards  one  another — an 
opinion  in  complete  accordance  with  the  advice  I  have  over  and 
over  again  endeavoured  to  impress  from  the  chair  and  in  our  dis- 
cussions— ^that  we  should  avoid  the  reprehensible  habit  in  which, 
I  am  grieved  to  say,  some  of  our  body  indulge,  much  to  their 
own  loss  and  discredit,  of  condemning  and  speaking  slightingly 
to  their  patients  and  to  the  public  of  the  practice  and  the  doses 
prescribed  by  others,  because  they  differ  from  their  own. 

An  -eq^ually  suicidal  course,  and  one  still  more  strange,  is  the 
pretension  of  some  of  the  so-called  Homoeopathic  practitioners  to 
speak  disparagingly  of  the  action  of  globules — ^nay,  to  deny 
that  they  have  any  action  at  all ;  they  at  the  same  time  affect 


Address  of  the  President  67 

to  hold  in  contempt  those  practitioners  who  prescribe  them» — 
whilst,  with  laughable  self-sufficiency,  they  claim  for  themselves 
a  superiority  of  intellect  in  having  discarded  them,  or  of  never 
using  anything  but  triturations,  tinctures,  and  pilules.  Now,  it 
is  indisputable  that  the  introduction  of  Homoeopathy  over  the 
Continent,  into  England  and  into  America,  was  mainly  if  not 
solely  eilected  by  the  employment  of  globules  impregnated 
with  medicine  in  the  treatment  of  disease  homoeopathically. 
I  can  answer  for  my  own  practice,  that  for  once  that  I  em- 
ploy or  have  employed  tinctures  or  triturations,  I  have  at  least 
prescribed  globules  sixty  times,  and  my  success,  I  believe,  has 
not  been  behind  that  of  my  neighbours,  and  for  many  years  I 
stood  quite  alone  in  England  the  only  Homoeopathic  physician. 
Drs.  Eomani,  Tagliabo,  Belluomini,  Dunsford,  and  others,  who 
followed  some  years  after  me,  almost  invariably  prescribed  medi- 
cine in  the  form  of  globules.  Dr.  Constantino  Hering,  of  Phila- 
delphia, who  was  among  the  first  to'  carry  Homoeopathy  from 
Grermany  to  America,  was,  and  I  believe  is,  a  strict  Hahne- 
mannist  with  respect  to  his  doses.  Most  of  the  distinguished 
Homoeopathic  physicians  known  to  me  in  France,  Italy,  and 
other  parts  of  the  Continent,  are  constantly  in  the  habit  of  pre- 
scribing globules.  And  among  my  friends  and  colleagues  in  Great 
Britain  I  have  no  hesitation  in  saying  it  is  my  firm  and  consci- 
entious conviction  that  those  in  the  most  extensive  and  success- 
ful practice  And  in  the  highest  repute,  prescribe  globules.  Let  me 
not  be  misunderstood  as  wishing  to  convey  that  either  I  or  they 
confine  our  prescriptions  to  medicines  in  the  shape  of  globules, 
or  have  tied  ourselves  up  never  to  employ  any  other  prepara- 
tions ;  on  the  contrary,  we  are  frequently  in  the  habit  of  pre- 
scribing tinctures,  triturations,  and  pilules,  as  well  as  globules, 
in  every  variety  of  attenuation  from  the  lowest  to  the  highest, 
according  to  the  more  or  less  susceptibility  of  our  patients  to 
the  action  of  the  medicines — according  to  the  phases  and 
variations  that  occur  during  the  treatment  of  our  cases,  and 
according  to  the  promptings  of  our  judgment  and  experience. 

5* 


68  A  ddress  of  the  President  ^ 

I  must  here  also  guard  myself  &om  being  thought  to  desize  to 
place  trammels  on  the  judgment  and  experience  of  others  in  pre- 
fening  to  prescribe  laigo  doses  only,  if  they  and  their  patients 
think  such  practice  best  It  is  against  their  illiberal  and  un* 
professional  conduct  only,  in  running  down  their  colleagues 
who  believe  in  the  efficacy  of  infinitesimal  doses,  and  conse- 
quently prescribe  them,  that  I  am  contending  here.  Kow, 
what  are  globules  ?  Merely  a  convenient  vehicle  or  method 
recommended  by  Hahnemann  for  prescribing  fractions  of  a 
drop  when  the  whole  is  not  considered  necessary  to  produce 
the  desired  efiTect,  or  when  it  is  desired  not  to  give  the  whole 
drop  at  once,  but  to  subdivide  it  into  more  fractions  or  smaller 
doses  than  it  would  be  convenient  to  do  by  diluting  it  in 
water.  It  is  notorious  that  some  of  these  practitioners  who 
proclaim  their  disbelief  in  globules,  prescribe  sometimes 
tinctures  in  the  3rd,  4th,  5th,  and  6th,  and  even  higher 
attenuations ;  consequently  they  avow  their  belief  in  the  mil- 
lionth and  billionth  of  a  drop  of  the  material  ding  they  pre- 
scribe. Well,  two  or  three  globules  impregnated  with  the 
1st,  2nd,  or  3rd  attenuation  contains  much  more  of  the 
crude  or  material  drug  than  any  drop  or  number  of  drops  of 
the  4th,  5th,  6th,  or  any  higher  attenuation;  so  that  upon 
their  own  showing,  and  upon  the  plea  advanced  by  them 
of  what  causes  the  efiQcacy  of  their  fietvourite  doses^  theii 
reason  for  expressing  disbelief  in  the  efiQcaoy  of  medicines 
given  in  globules  as  the  vehicle,  is  purely  and  simply  an 
absurdity. 

Another  strange  idea  which  has  taken  hold  of  some  of  the 
so-called  Homoeopathic  practitioners  is,  that  there  is  little  or  no 
efficacy  in  medicines  prepared  by  the  centesimal  scale  adopted  and 
recommended  by  Hahnemann,  and  which  has  been  in  general 
use  sincd  the  commencement  of  Homoeopathy,  they  preferring 
the  decimal  preparations.  I  remember  having  a  consultation 
with  one  of  these  gentlemen^  who  on  my  suggesting  a  medicine 
which  he  had  not  prescribed  in  the  case,  readily  consented. 


Unpublished  Letters  of  Hahnemann,  69 

but  demurred  somewhat  on  my  stating  the  attenuation  in 
which  I  considered  it  would  be  most  efficacious,  and  he  hoped  I 
would  not  object  to  his  giving  a  decimal  preparation  instead, 
as  he  had  for  some  time  ceased  to  employ  any  other.  On 
inquiring  what  dilution  he  proposed,  he  named  the  6th.  I 
asked  why  he  preferred  that  to  the  one  I  had  suggested,  and 
anything  more  startling  and  illogical  than  his  reply  cannot  well 
be  imagined ;  for,  to  my  astonishment,  he  said,  because  it  is 
much  stronger  and  more  active.  Now,  as  I  had  recommended 
the  3rd  attenuation,  which  is  exactly  identical  in  strength  in  the 
centesimal  scale  with  the  6th  attenuation  in  the  decimal, 
you  will  understand  my  surprise.  I  endeavoured  to  point  this 
out  to  him,  but  without  success.  Such  powers  of  calculation 
are  enough  to  raise  the  ghost  of  Cocker ! 

I  have  now,  I  believe,  touched  upon  the  different  matters 
which  have  engaged  the  attention  of  the  Society  during  the 
past  session,  and  have  candidly  expressed  the  opinions  which 
my  forced  absence  from  the  Society's  meetings  prevented  my 
doing,  whilst  summing  up,  in  the  course  of  your  debates. 


UNPUBLISHED  LETTEES  OF  HAHNEMANN. 

To  Dr.  Stapp. 

Koethen,  May  5th,  1831. 
Deab  Friend  and  Colleague, 

I  must  get  the  horrid  chancre  dissertation  out  of  the 
house,  and  so  I  send  it  you  along  with  this,  as  I  should  have 
done  long  ago. 

I  also  send  you  a  very  nice  guide  for  patients  in  search  of 
assistance,  by  the  Baron  Yon  Bonninghausen,  in  Munster.  I 
beg  you  will  send  a  copy  to  Dr.  Schweikert,  for  publication  in 
lis  journal,  as  I  do  not  know  whether  he  is  in  Grimma.    "WIl^ 


70  UnpubliMhid  Letters  of  Hahn§manjk. 

do  yoa  say  of  the  article  in  the  92xid  number  of  Yo88*s 
Journal,  by  Pn^fossor  Schulze.  of  Berlin,  upon  the  Homceobiotio 
lleiliciiio  of  ruracelsm  ?  According  to  him  I  haye  taken  my 
systom  out  of  this  man's  writings  (umntelligible  gibberish !), 
but  have  not  rightly  understood  it.  and  have  confused  it  in  the 
taking.  Paraoelsrs  understood  it  better  !  From  this  point  no 
one  has  yet  attacked  Homoeopathy — it  was  still  to  da  Do  you 
know  anything  of  a  Homceopathic  physician.  Dr.  Mayerhofeir> 
of  r>remen,  who  has  an  immense  practice,  and  is  Teiy  highly 
esteemed  by  his  patients  ?  I  heard  of  him  &om  a  friend  who 
had  liveil  for  some  time  in  Bremen. 

After  you  have  thoughtfully  perused  the  work  upon  the 
Katuml  Birth,  I  beg  you  will  return  it  as  soon  as  yon  can,  for 
the  theologians  hero  are  most  anxious  to  see  it. 

I  am  prevented  writing  more  just  now,  and  so  I  mnst  con- 
clude with  my  greeting  to  your  dear  household. 

Saiiuxl  Hahneicann. 

To  Dr.  Stapf. 

Koethen,  August  5ih,  1831. 

Dear  Friend  and  Colleague, 

I  send  you  along  with  this  a  globule  ot  the  30th  of  Carb. 
An.,  and  I  hope  it  will  prove  nsefuL  I  trust  that  she  walks  in 
strict  obedience  to  my  warning  letter.  I  am  greatly  pleased  to 
hear  of  the  improvement  of  my  beloved  Hermann.  Next  to 
Capsicum,  Carb.  Anim.  is  of  the  greatest  service  in  this  epidemic 
of  fever. 

I  have  had  Straube,  that  excellent  man  and  accomplished 
and  modest  artist,  with  me  frequently,  and  I  have  come  to  like 
him  dearly,  as  well  for  his  own  sake  as  for  his  convictions  in 
favour  of  our  science. 

Preu,  in  Numbei^,  I  like  mnch,  and  am  obliged  to  you  fop 
lotting  mo  see  his  letter.  So  long  as  the  Allopaths  give  ns 
false  pictures  of  the  cholera,  i^resenting  it  as  a  combination  of 


Unpublished  LsUers  of  Hahnematm.  71 

vomiting  and  diarrhoea^  it  was  natural  that  we  unfortunate 
Homoeopaths,  at  a  distance  and  unable  to  obsenre  for  onrselveSy 
should  be  misled  unto  the  belief  of  the  specific  value  of 
Veratrum  and  Arsenicum  in  the  disease;  but  the  true  discrip- 
tion  given  by  a  Homoeopathist  shows  that  the  essential  cha- 
racter of  the  disease  is  wholly  different ;  that  it  is  an  affection 
of  the  whole  system,  which  only  at  its  termination  assumes  the 
form  of  convulsions  and  paralysis,  accompanied  by  wateiy 
vomiting  and  purging  only  in  certain  cases;  in  most  cases 
nothing  of  this  takes  place-— only  rapid  death.  Here,  neither 
Veratrum  nor  Arsenicum  can  be  expected  to  do  good.  Schreter 
writes  from  Lemberg,  that  he  effected  something,  but  not  much, 
by  means  of  Veratrum,  and  when  that  did  no  good  Camphor 
was  the  remedy  (he  had  just  got  my  article  upon  Camphor). 

I  was  told  within  the  last  two  days  by  an  eye-witness  that 
when  cholera  ravaged  Odessa,  some  months  ago,  the  treatment 
pursued  there  was  rubbing  the  patient  over  with  Camphor, 
which  rescued  many  of  them;  he  himself  had  treated  nine 
patients  with  Camphor,  and  all  of  them  recovered.  What 
further  testimony  do  we  require  ? 

The  medical  authorities  in  Berlin  and  Vienna  have  refused 
to  allow  my  article  upon  the  utUity  of  Camphor  to  be  pub- 
lished in  the  JoumaL  In  Berlin  it  is  to  be  printed  by  a  book- 
seller, with  Stiiler's  introduction.  I  wish  you  would  allow  the 
explanations  in  reference  to  the  dose  I  have  written  about  this 
introduction  of  Stiiler's,  who  makes  some  malicious  observations 
about  the  size  of  the  dose,  to  be  read  at  the  meeting  of  the 
10th  of  August. 

I  have  also  been  asked  by  a  Leipsig  bookseller  to  allow  binn 
to  publish  the  articla  It  wiU  shortly  appear,  printed  by 
Gluck.  He  is  to  sell  it  for  nine  gt.  gr.  I  have  prepared  it  in 
an  entirely  popular  form,  omitting  all  scientific  details. 

My  likeness  on  steel  is  not  yet  ready,  else  I  should  gladly 
send  it  you.     I  am  much  pleased  at  yours. 

Bjominel  ha^  managed  that  article  capitally.     I  trust. that 


*'.*.'ii-?  vll   *i*-tr  '^  2X1*   ^  -P2SS  ai  lieir  i»g.L -^ 
•-    V  .   -_  vr  !.:.;_  LA"*  "LZiti  Liii  '.ra=fi  "Su-  ^/'Jf 


;.         .r:     -^     .■.  v    ._iz  ^tS^M. '  JL.    ^    «i^    iJC 


;^nnals  ai  tbe  ^nspital. 


r;o;;Mj;i>fNG  lkcture  on  laiEOiAnsM.— ox  the 

liO.h  A  NO  TMK  ALTKKNATIOX  OF  THE  MEDICINE. 
I5y   \)\i.  Kr;s.SELL. 

(li.MM  MKf/,  r  pr,f.l,poTK!(l  Ujo  coDsidoratioii  of  the  methods 
n(  ii<lfiiihiftl,frin|^  HotiinopHiliic  medicines,  that  I  might  treat 
Mil  iiihjirl.  of  I.Ik'  <Ioh(!  with  Horiictliiiig  like  the  fuLiess  its 
iiii|iMihitM  n  (l('iiinii(l('(|.  And  now  that  I  come  to  fulfil  my 
|il''li"  ,  iiiid  Id  I'lilcr  ii|M)n  (I  ({iH'.st.ion  that  has  caused  so  much 
iMid  mil  h  \Miiiii  diMniMMJon,  I  frcl  tho  greatest  hesitation  and 
it.liii  liiiM  i>  III  iiiiliMiii)r  ii|M»n  Mm  t'liHk.  It  is  quite  out  of  my 
|iM'M  I  In  jilvp  nvnii  Mm  lirirfpHt.  (uiMinc^  of  controversies  both 
MiHiiii  mid  wiMiniil.  mil'  <i\vu  l)od\\  which  this  question  has 
(III  Hid  ,  tMiiliiivniMJnrt  iMiiidiK^hul  with  luuch  ability  on  both 
»«iili><  lull  iimI>  Hlwiiyri  wlMk  |Mirloot  nuukmr  and  equanimity  on 
I'iMiii  iildti 

r.i.i.iiii)!  Hiitiii  Ity   liir  (ho  phmout  at  toasts  lot  us  attempt 
\s\\\\\  III  iinihiiMlHud  whu(  iho  iUOWuIUoh  tux>  ^vhich  have  pre- 


Lecture  hy  Dr.  Russell,  73 

vented  the  some  unanimity  among  the  adherents  of  Hahnemann 
in  reference  to  the  proper  dose  of  Homoeopathic  medicines  as 
happily  prevails  in  regard  to  the  fundamental  dogma  oh  which 
his  system  is  erected,  and  fix)m  which  the  minor  proposition 
that  a  substance  chosen  according  to  the  principle  expressed 
in  the  maxim,  "  SimUtcs  similibus  curarUur,''  should,  to  effect 
a  cure,  be  given  in  a  quantity  infinitely  less  than  practitioners 
of  medicine  had  been  in  the  habit  of  employing  up  to  his 
tima  To  use  his  own  words,  as  he  expresses  himself  in  the 
278th  paragraph  of  the  Organon — ^"Here  the  question  arises, 
what  is  the  most  suitable  degree  of  minuteness  for  affording 
certain  and  gentle  relief? — ^how  small,  in  other  words,  must  be 
the  dose  of  each  individual  medicine  (selected  according  to  the 
Homoeopathic  principle  for  a  case  of  disease)  in  order  that  it 
shall  best  effect  a  cure?  .  .  .  Pure  experiments,  careful 
observation,  and  accurate  experience  can  alone  determine  this ; 
and  it  would  be  absurd  to  adduce  the  large  doses  of  unsuitable 
(Allopathic)  medicines  of  the  old  system,  which  do  not  touch 
the  diseased  part  of  the  organism  homoeopathically,  but  act 
only  on  those  parts  unaffected  by  disease,  in  opposition  to  what 
pure  experience  pronounces  respecting  the  requisite  minuteness 
of  the  doses  for  effecting  Homoeopathic  cures."  The  question 
is  here  fairly  stated  to  be  one  which  can  be  correctly 
answered  only  by  eocperiment,  observation^  and  experience. 

Let  us  consider  how  it  happens  that  we  have  up  to  this  time 
obtained  nothing  but  confused,  evasive,  and  contradictory  replies 
to  the  interrogations  put  to  this  collective  oracle. 

At  the  outset  of  the  inquiry  we  perceive  a  fundamental 
distinction  between  the  processes  of  investigating  the  question 
of  the  proper  dose  of  an  Allopathic  and  a  Homoeopathic 
medicine.  In  Allopathic  practice  the  design,  as  Hahnemann 
states,  is,  by  acting  on  a  healthy  organ,  to  induce  a  salutary 
change  on  the  part  of  the  body  affected  with  diseasa  For 
example,  in  a  case  of  rheumatic  inflammation  oi  the  knees, 
our  Allc^athic  practitioner  might  give  a  purgative,  a  AtaaMvi 


74  Lecture  hy  Dr.  EusaelL 

or  a  sudorific,  and  opiate.  If  he  is  asked  how  he  knows  what 
quantity  of  any  of  these  drugs  ought  to  be  administered,  his 
answer  is  ready, — "  that  will  depend  upon  the  amount  of  effect 
required."  The  effects  of  the  substances  he  employs  have  been 
ascertained  with  greater  or  less  precision  by  scientific  processes. 
It  is  known  to  a  nicety  what  quantity  of  castor  oil  will  operate 
as  a  purgative,  and  what  quantity  of  opium  is  required  to  pro- 
duce sleep.  Making  a  certain  allowance  for  the  disturbing 
action  of  morbid  causes,  he  selects  his  dose  of  medicines 
according  to  the  table  put  into  his  hands  by  the  toxicologist 
For  an  Allopathic  practitioner  to  give  the  millionth  of  a  drop 
of  castor  oil  to  induce  purgation,  or  the  billionth  of  a  grain  of 
opium  to  procure  sleep  would  be  a  manifest  absurdity.  His 
aim  is  definite,  and  the  means  to  attain  it  equally  so.  The 
question  is  not  now  whether  or  not  purgation  be  desirable; 
but  supposing  it  to  be  so,  how  is  it  to  be  obtained  ?  He  can 
graduate  his  dose  so  as  to  produce  to  considerable  nicety  the 
amount  of  the  particular  action  he  wishes,  because  he  is  acting 
upon  the  sound  part  of  the  frame,  according  to  physiological 
principles  established  on  the  secure  basis  of  repeated  experi- 
ment. But  the  position  of  the  Homoeopathic  practitioner  is 
wholly  dijfTerent.  The  effects  he  strives  to  obtain  are  not 
positive,  but  negative.  For  what  is  a  ciire  but  the  n^ation  of 
disease?  The  more  perfect  the  method,  the  more  entirely 
absent  is  all  positive  effect.  This,  then,  is  his  problem — 
"  Given  thirty  different  doses,  all  of  which  have  the  power  of 
acting  curatively  upon  a  diseased  organ,  while  none  of  them 
produce  any  appreciable  effect  upon  the  sound  parts  of  the 
body — ^how  is  he  to  ascertain  which  one  out  of  the  thirty  exerts 
a  curative  power  in  the  strongest  degree  V*  The  simplest^  and, 
indeed,  the  only  way  to  solve  this  problem  is,  by  a  seriies  of 
trials  of  the  same  medicine  in  different  dilutions  administered 
in  similar  circumstances.  But  at  the  very  threshold  of  the 
investigation  we  encounter  the  almost  insurmountable  obstacle 
of  contriving  experiments  which  shall  meet  the  requirements  of 


Lecture  by  Dr.  Rtusell.  75 

the  casa     The  difficulties  that  beset  the  whole  class  of  such 
inquiries  are  thus  expressed  by  Mr.  J.  Stuart  Mill,  in  his  great 
work  upon  Logic — "  Let  the  subject  of  investigation  be  the 
conditions  of  health  and  disease  in  the  human  body-— or,  for 
greater  simplicity,  the  conditions  of  recovery  from  a  given  dis- 
ease ;  and  in  order  to  limit  the  question  still  more,  let  it  be 
confined  in  the  first  instance  to  this  one  inquiry,  Is,  or  is  not, 
a  particular  drug — mercury,  for  example — ^a  remedy  for  that 
disease  ?     .     .     .     When  we  devise  an  experiment  to  ascer- 
tain the  effects  of  a  given  agent,  there  are  certain  precautions 
which  we  never,  if  we  can  help  it,  omit.    In  the  first  place,  we 
introduce  the  agent  into  the  midst  of  a  set  of  circumstances 
which  we  have  exactly  ascertained.     It  need  hardly  be  re- 
marked how  far  this  condition  is  from  being  realized  in  any 
case  connected  with  the  phenomena  of  life ;  how  fiEur  we  are 
from  knowing  what  are  all  the  circumstances  which  pre-exist 
in  any  instance  in  which  mercury  is  administered  to  a  living 
being.     This  difficulty,  however,  though  insuperable  in  most 
cases,  may  not  be  so  in  all;  there  are  sometimes  (though  I 
should  think  never  in  physiology)  concurrences  of  many  causes 
in  which  we  yet  know  accurately  what  the  causes  are.     But 
when  we  have  got  clear  of  this  obstacle,  we  encounter  another 
stUl  more  serious.     In  other  cases,  when  we  intend  to  try  an 
experiment,  we  do  not  reckon  it  enough  that  there  be  no  cir- 
cumstances in  the  case  the  presence  of  which  is  unknown  to 
us ;  we  require  also  that  none  of  the  circumstances  which  we 
do  know  shall  have  effects  susceptible  of  being  confounded 
with  those  of  the  agent  whose  properties  we  wish  to  study. 
We  take  the  utmost  pains  to  exclude  all  canises  capable  of  com- 
position  with  the  given  cause ;  or,  if  forced  to  let  in  any  such 
causes,  we  take  care  to  make  them  such  that  we  can  compute 
and  allow  for  their  influence,  so  that  the  effect  of  the  given 
cause  may,   after  the   subduction  of  those  other  effects,  be 
apparent  as  a  residual  phenomenon.     These  precautions  are 
inapplicable  to  such  cases  as  we  are  now  considering.     .     .     . 


7  6  Lecture  hy  Dr.  Russell. 

Anything:;  like  a  scientific  use  of  the  method  of  experiment  in 
those  coinplicatod  cases  is  therefore  out  of  the  question.     We 
can,  in  the  most  favourable  cases,  only  discover  by  a  succession 
of  trials,  tliat  a  certain  cause  is  ver}"  often  followed  by  a  certain 
efreft/' — Mill's   "Logic,"  vol.  i.  p.  529.     I  have  quoted  this 
utt(»rance  of  inexorable  Logic,  not  that   I  believe  it  to  be  at 
all  impossible  to  establish  by  a  sufficient  number  of  instances. 
that  the   administration  of  a  certain  remedy  is  followed,  by 
virtue  of  the  law  of  causation,  by  the  cure  of  certain  forms  of 
morbid  action,  but  to  put  us  on  our  guard  in  dealing  with  the 
question  before  us,  by  exhibiting  the  category  to  which  the 
problem  belongs.     It  is  one  of  mixed  causes.     Without  under- 
valuing the  power  of  a  medicine  to  effect  a  cure,  yet  it  is 
obvious  that  this  curative  action  is  only  one  of  several  causes 
which  bring  about  the  recovery  of  a  patient.     The  duty  of  a 
physician  is  not  to  make  experiments  upon  the  sick  entrusted 
to  his  care,  in  order  to  determine  with  scientific  precision  the 
exact  value  of  a  given  remedy ;  it  is,  to  employ  all  the  means 
in  his  power  to  accomplish  the  object  of  his  vocation.     He 
must,  to  the  utmost  of  his  ability,  remove  from  his  patient  all 
noxious  agencies,  and  accumulate  all  salubrious  influences  about 
him.     He  must  improve  his  diet,  his  habits  of  exercise,  or  of 
rest ;  he  must  convey  hope  and  confidence  if  possible  into  his 
mind ;  and  in  short,  he  must  exhaust  all  his  ingenuity  for  the 
welfare  of  the  sufferer,  just  as  if  he  had  no  medicine  to  give. 
Into  this  multitude  of  healing  forces  he  drops  his  globula 
Let  it  not  be  supposed  that  I  regard  the  globule  so  adminis- 
tered as  a  trifling  addition ;  on  the  contrary,  I  am  firmly  per- 
suaded that,  in  most  cases,  it  exerts  greater  powers  in  bringing 
about  the  happy  result  than  aU  the  other  influences  put  toge- 
ther.    Nevertheless,  to  overlook  the  other  co-operating  causes 
of  the  effect  would  be  as  great  an  error  on  our  part  as  is  the 
mistake  of  our  opponents  in  ascribing  our  cures  to  these  causes 
alone.     Let  us  now  fairly  confront  the  problem.     The  question 
-"  Here  are  thirty  different  doses  of  the  same  substance, — 


Leettt/re  by  Dr.  Riissell.  77 

all  the  thirty  possess  the  power  of  curing, — ^to  ascertain  which 
of  the  thirty  possess  their  power  in  the  highest  d^pree?"  The 
only  conceivable  method  of  setting  about  the  investigation  is 
to  institute  a  series  of  experiments.  What  are  the  conditions 
required  to  give  such  experiments  any  scientific  value  ?  It  is 
obvious  that  the  physician  must  begin  by  selecting  thirty  cases 
of  the  same  description  in  every  particular;  that  the  cases 
.iQiust  be  of  some  complaint  which  does  not  tend  to  a  speedy 
spontaneous  recovery ;  that  for  each  of  these  cases,  the  medi- 
cine experimented  on  is  equally  well  suited;  that  all  the 
persons  are  placed  in  exactly  similar  circumstances  as  regards 
the  other  sanative  influences ;  that  they  are  all  equally  sensitive, 
naturally,  to  the  action  of  the  particular  remedy  which  is  being 
tried ;  that  the  experiment  shall  be  made  by  the  same  physician, 
at  the  same  season  of  the  year,  surrounded  by  the  same  epidemic 
and  atmospheric  influences ;  and  that  it  shall  last  for  several 
weeks,  or  even  months.  But  one  series  of  such  experiments 
could  not  by  any  possibility  afford  any  trustworthy  results.  It 
would  require  many  such  series.  Now  I  ask, — ^has  this  ever 
been  attempted,  or  is  it  likely  that  it  ever  will  be  ?  Common 
sense  tells  us  that  the  difficulties  of  performing  such  experi- 
ments are  absolutely  insurmoimtable.  But  till  they  are  over- 
come>  I  do  not  see  how  we  can  even  expect  to  arrive  at  a  law 
regarding  the  dose.  This  can  be  attained  by  a  process  of  induc- 
tion alone ;  and  the  only  facts  available  for  such  induction  must 
be  obtained  by  some  such  process  of  experimentation  as  I  have 
sketched.  All  d  priori  attempts  to  frame  such  a  law  have 
utterly  failed. 

The  practice  of  giving  medicine  in  'extremely  minute  doses, 
in  cases  treated  homceopathically,  rests  partly  upon  reason, 
partly  upon  experiment.  The  rationalty  of  the  practice  was 
explained  sixty  years  ago  by  Hahnemann,  and  with  more  force 
and  clearness,  in  my  opinion,  than  by  any  subsequent  writer 
on  the  subject  In  a  letter  addressed  to  Hufeland,  and  pub- 
lished in  his  celebrated  Journal  in  the  year  1801,  Hahnemann 


7  8  Lecture  by  Dr.  Ruuell. 

writes: — "You  ask  me  what  eflPect  can  l-100,000ih  part  of 
a  grain  of  Belladonna  have  ?  The  word  can  I  dialike ;  it  ia 
apt  to  lead  to  misconceptions.  Our  compendiuxns  have  alxeady 
decided  what  medicines  can  do  when  given  in  certain  doses; 
and  they  have  told  us  exactly  what  we  are  to  use ;  they  have 
determined  these  matters  with  such  precision  that  we  might 
look  on  these  volumes  as  our  sacred  books,  if  medical  dogmas 
were  to  be  believed  as  articles  of  faith.  But,  thank  Heaven, 
this  is  not  the  case ;  it  is  well  known  that  our  works  on 
Materia  Medica  rest  on  anjrthing  but  pure  experience — ^that 
they  are,  in  fact,  the  inanities  of  our  great-grandfathers  re- 
peated without  examination  by  their  great-grandsons.  Let  us 
not,  then,  inquire  of  these  compendiums,  but  let  us  ask  nature 
what  effect  has  1-1 00,0 00th  of  a  grain  of  Belladonna?  But 
even  in  this  shape  the  question  is  too  wide ;  it  must  be  put  in 
a  more  definite  form  for  reply,  by  the  addition  of  the  qualifica- 
tions, ubi,  quo  modo,  quando,  quibus  auxiliis. 

"  A  hard  dry  pill  of  extract  of  Belladonna  produces  on  a 

P  robust,  perfectly  healthy  peasant  or  labourer  usually  no  effeck 

But  from  this  it  by  no  means  follows  that  a  grain  of  this  ex- 

U  tract  would  be  a  proper  or  too  small  a  dose  for  such  a  man  if 

: ;  he  were  ill,  or  if  the  grain  were  dissolved.     The  most  healthy 

)A  and  robust  labourer  will  be  affected  with  very  violent  and  even 

{;J  dangerous  symptoms  from  one  grain  of  the  extract  of  Bella- 

i;  donna,  if  this  grain  be  dissolved  in,  say,  two  pounds  of  water, 

and  if   he  take  it  in  spoonsful  within  six   or  eight   houis. 

These  two  pounds  will  contain  about  100,000  drops.     Now,  if 

one  of  these  drops  be  mixed  with  other  2,000  drops  of  water, 

and  twenty  drops  of  this  mixture  be  given  every  two  honis, 

they  will  produce  effects  not  much  less  violent  if  the  man  to 

whom  they  are  administered  be  HI.     This  dose  contains  about 

one-millionth   part  of  a  grain.      A  few  teaspoonfols  of  this 

.,  mixture  will,  I  aGBrm,  bring  to  the  brink  of  the  grave  a  person 

seriously  ill  of  a  disease  to  which  the  action  of  Belladonna 

II  bears  a  close  resemblance. 


Lectu/re  ly  Dr.  Russell.  79 

'"The  liard  pill  of  some  grains  of  Belladoxma  finds  few  points 
of  contact  in  the  healthy  body ;  it  glides  almost  nndissolved 
through  the  intestinal  canal,  protected  by  its  layer  of  mucus. 
But  it  is  very  different  with  the  same  substance  when  dissolved. 
Let  the  solution  be  as  weak  as  it  may,  on  being  received  into 
the  stomach  it  acts  on  a  much  larger  surface  and  excites  more 
severe  symptoms  than  the  pill  which  contains  a  million  times 
the  amount  of  medicine  is  capable  of  doing." 

In  this  letter,  written  more  than  sixty  years  ago,  we  have 
the  most  explicit  statement  of  the  conditions  which  combine 
to  make  the  administration  of  medicines  in  minute  doses  ob- 
viously rational  These  conditions  are  twofold;  the  first  is 
that  the  substance  shall  be  prepared  in  such  a  way  as  to  enable 
it  to  come  in  contact  with  a  larger  surface  of  a  part  of  the 
body  highly  endowed  with  nervous  sensitiveness.  This  is  a 
physiological  reason.  A  healthy  man  would  be  poisoned  by  a 
dose  of  Belladonna  or  Opium,  if  given  in  solution,  which 
would  be  comparatively  innocuous  if  given  in  the  form  of  a 
pilL  The  second  condition  is  pathological,  viz.,  that  an  organ 
in  a  morbid  state  is  morbidly  alive  to  morbific  agencies — as 
the  inflamed  eye  to  intense  light,  inflamed  joints  to  rough 
movement,  &c. 

K  Hahnemann  had  stopped  at  this  point,  he  might  have 
effected  what  I  may  call  a  bloodless  revolution  in  medicine. 
But  he  did  not  stop  hera  A  few  years  after  writing  the 
passage  just  quoted,  he  uttered  the  astonishing  proposition  that 
a  globule  of  the  decillionth  of  many  substances  known  to  be 
wholly  inert  in  massive  doses,  had  the  property  of  exerting 
an  enormous  power  upon  the  living  organisms  when  it 
was  aflSicted  with  symptoms  of  disease  similar  to  those  these 
substances  produced  when  they  were  prepared  and  administered 
in  a  certain  way.  It  is  obvious  that  in  making  such  an 
affirmation,  Hahnemann  left  behind  all  A  priori  probabilities  of 
its  truth.  The  reasoning  he  employed  to  render  credible  that  a 
millionth  of  a  grain  of  Belladonna  was  more  potent  than  the 


80  I^durt  hy  Dr.  RusmU. 

whole  grain,  inasmuch  aa  the  former  acted  on  a  larger  anrbce^ 
is  inapplicable  in  regard  to  a  globule  of  the  30th  dilution  of 
calcanM  for  example,  placed  upon  the  tongua  Up  to  a  cer- 
tain point,  analogy  is  all  in  favour  of  minute  doses;  beyond 
that  j)oint  I  confess  it  seems  to  me  that  we  can  derive  little,  if 
any,  support  from  analogy. 

On  what  then  do  we  rely  if  we  entertain  the  belief  that  a 
globule  of  the  decillionth  of  a  grain  of  Calcarea  is  a  powerful 
medif.ine  ?  Simply  and  exclusively  on  testimony  and  our  own 
observations. 

Let  us  consider  the  evidence  in  favour  of  this  astonishing 
proposition.  The  first  witness  is  Hahnemann  himseli  Is  his 
testimony  worthy  of  credit  in  this  matter  ?  We  require  of  a 
trustwoi-thy  witness  that  he  shall  be  competent  in  knowledge 
of  the  subject ;  and  that  he  shall  be  veracious  and  accurate  in 
his  statements.  Of  Hedinemann's  acquaintance  with  the  sub- 
ject, and  capacity  of  observing  facts  in  regard  to  the  action  of 
the  high  dilutions  of  medicine,  there  is  no  need  to  speak.  He 
had  ample  opportunities  and  undeniable  ability  for  the  task. 

I5ut  what  of  his  accuracy  and  trustworthiness  as  a  recounter 
of  observations  ?  If  Hahnemann  be  not  accurate  and  trust- 
wortliy  as  a  critical  observer  and  faithful  narrator  of  his  own 
observations  and  those  of  others,  then  the  whole  feibric  of 
Ilomoiopathy  rests  on  an  unsound  foundation;  for  be  it  re- 
membered that  nine-tenths  at  least,  if  not  nineteen-twentieths, 
of  the  observations  upon  the  actions  of  medicines  which  are  in 
daily  use  by  Homoeopathists  are  derived  fix>m  Hahnemann's 
Materia  Medica :  and  observe  what  an  tmenviable  position 
those  men  occupy  who  are  in  the  daily  habit  of  employing  the 
medicines  introduced  into  practice  by  Hahnemann,  prescribing 
Belladoima,  Pulsatilla,  Bryonia,  &c.,  not  because  they  them- 
flclvos  discovered  the  virtues  of  these  drugs,  but  because 
Halmomann  has  done  so,  and  left  directions  for  their  proper 
use,  and  who,  although  tacitly  acknowledging  his  trustworthi- 
ness, yet  tell  us  that  they  have  no  faith  in  globules  of  the  high 


Lecture  by  Dr,  Rtissell.  8 1 

dilutions  I  I  could  quite  understand  their  position  if  they 
were  to  say,  We  have  tried  both  the  low  dilutions  and  the  high 
dilutions,  and  we  find  the  latter  of  no  avaiL  But  I  do  not 
find  that  those  who  reject  Hahnemann's  statements  in  reference 
to  the  action  of  the  high  dilutions  have  submitted  them  to  a 
careful  course  of  experimentation.  On  the  contrary,  it  seems 
to  me  that  they  act  exactly  as  they  blame  the  opponents  of 
the  homoeopathic  system  for  acting — ^that  is,  they  deny  that 
these  doses  can  act,  because  it  is  against  their  notions  of  what 
is  possible.  But  who  shall  say  what  is  possible  and  what  is 
impossible  ?  Facts  alone,  facts  carefully  observed  and  accu- 
rately reported  by  witnesses  beyond  suspicion,  can  decide  such 
a  question  as  this.  Hahnemann,  as  we  know,  with  nothing  to 
gain  and  all  to  lose  by  a  false  step,  firmly  maintained  his 
course,  and  in  cases  of  the  severest  illnesses  of  those  most 
dear  to  him,  trusted  in  his  globules  of  the  30th  dilution.  Since 
his  time  a  multitude  of  other  observers  have  borne  testimony 
to  the  efficacy  of  these  extremely  minute  doses.  If  we  were  to 
poU  all  the  homoeopathic  practitioners  over  the  globe,  and  put 
the  question  to  them,  "  Do  you  believe  that  a  dose  of  Calcarea 
of  the  30th  dilutionhas  any  power  ? "  I  am  convinced  that  there 
would  be  an  overwhelming  majorrt-  in  favour  of  the  affirma- 
tive. 

All  who  have  earnestly  devoted  themselves  to  the  study  of 
the  Materia  Medica,  and  to  an  experimental  verification  of 
Hahnemann's  original  experiments  upon  himself  with  the 
medicines  it  contains,  have  borne  testimony  to  the  wonderful 
fidelity  and  accuracy  of  all  the  statements  that  rest  upon  his 
own  personal  observations.  Are  we  then  to  throw  all  these  ob- 
servations to  the  winds,  and  to  begin  a  reconstruction  of  this 
great  edifice,  which  looks  rather  like  the  growth  of  ages  than 
the  effort  of  one  man?  Those  who  propose  that  we  shall, 
hare  formed  a  very  faint  idea  of  the  difficulties  that  beset  a 
abourer  in  the  path  of  experiment  with  medicinal  substances ; 
in  Iftct,    nobody    who    practises    Homoeopathy    can  serio\x%V 

VOL.  in.  ?» 


H2  Lecture  hy  Dr.  Russdl, 

liiako  >n  wilil  a  ]>roi>osal,  for  he  stultifies  his  own  piactice  on 
the  vi-ry  outset.  No;  logically  there  is  no  alternative:  either 
wf  iim-t  jicecpt  the  statement  of  Hahnemann  and  his  followers, 
that  ;.'1m1iu1(.'s  of  the  decillionth  of  a  grain  of  such  substances  as 
(.'ill'  ar»*;i,  Carln),  Silic«»a,  have  a  most  powerful  action  on  the 
di>or<l-iv.l  frame  of  man,  or  we  must  reject  Hahnemann's 
Mat<']i:i  Medica,  out  of  which  all  the  manuals  of  practice  are 
dcri\  <m1.  If  we  are  not  prepared  for  the  latter  altematiYe,  what 
\m:()\wr<  of  the  lamentation  we  so  often  hear  about  these  high 
dilutions  ?  If  Hahnemann  be  correct  in  his  statements,  then 
he  iiifide  undoubtedly  as  great  a  discovery  when  he  ascertained 
that  thf're  was  me<liciual  power  in  the  decillionth  of  a  grain  of 
lime  or  charcoal  as  was  ever  made  in  this  region  of  physics. 
Shall  we  say  this  discovery  is  of  no  importance — a  thing  rather 
to  be  ashamed  of  because  it  exposes  us,  who  avow  a  belief  in 
it,  to  the  ridicule  of  those  who  despise  Hahnemann,  his  doc- 
trines, and  his  disciples  ?  Were  we  to  do  so,  we  should  deserve 
the  contempt  of  his  opponents,  whom  we  ignobly  tried  to 
propitiate  by  denying  our  master,  to  avoid  the  scorn  of  the 
medical  world. 

If  on  the  one  hand  it  is  impossible  to  ascertain  by  the 
strictly  Baconian  method  of  scientific  induction  the  relative 
value  of  dift'erent  doses  of  the  same  medicine,  and  on  the  other 
hand  there  is  ample  evidence  for  all  the  various  doses  ranging 
from  the  pure  tincture  up  to  the  decillionth  of  a  drop  pos- 
sessing power,  more  or  less,  to  cure  diseases,  what  is  the 
I)ractical  conclusion  to  which  we  are  forced  to  arrive  ?  It  is 
this.  The  dose  is  not  to  be  determined  by  any  geneial  law ; 
each  individual,  each  form  of  disease,  each  variety  of  the  innu- 
merable conditions,  the  sum  total  of  which  compose  a  human 
life,  has  its  own  appropriate  dose.  The  dose  proper  for  this  man 
to-day  will  bo  improper  for  him  to-morrow;  the  one  best  suited 
for  this  woman  is  not  the  best  for  that  child ;  but  all  men  are 
not  to  have  a  different  dose  from  all  women  and  all  children. 
Tlui  (luostlon  of  the  proper  dose  is  like  that  of  the  most  suit- 


Lecture  by  Dr,  RusselL  83 

able  food.     The  only  answer  we  can  give  is,  that  that  is  best 
which  agrees  best  with  the  individual  who  uses  it.     In  the 
same  way  we  say  that  dose  is  best  which  does  its  work  most 
perfectly.     But  if  we  are  asked  how  shall  we  determine  before- 
hand what  particular  dose  to  select,  our  answer  is,  "  It  is  im- 
possible to  give  any  general  rule — ^it  depends  upon  the  indi- 
vidual sensitiveness  of  the  patient ;  and  to  be  able  to  form  an 
accurate  estimate  of  this,  requires  the  special  medical  faculty, 
the  possession  of  which,  in  a  greater  or  less  proportion,  is  the 
grand  reason  of  the  difference  in  the  success  of  one  practitioner 
as  compared  to  another.     The  same  kind  of  rapid  perception, 
almost  intuition,  which  enables  any  physician  to  form  at  once 
an  accurate  judgment  of  the  nature  of  a  case,  will  enable  such 
a  man  also  to  form  a  correct  opinion  as  to  the  amount  of  sen- 
sitiveness, and  consequently  the    most  appropriate  dose.     In 
short,  it  belongs  to  the  unteachable  part  of  the  art  of  medicine, 
not  to  the  teachable  sciences  which  go  to  form  that  art.     The 
great  practical   lesson  to  be  leamt  from  all  that  has  been 
written  on  the  subject  I  believe  to  be  this :  "  That  man  will 
effect  most  cures,  who,  besides  being  duly  instructed  in  the 
action  of  the  medicines,  and  possessing  in  greatest  measure  the 
other  qualifications  for  success,  is  least  bound  by  any  rules  in 
regard  to  the  doses  he  employs — ^who  ranges  most  freely  from 
the  lowest  to  the  highest,  and  from  the  highest  to  the  lowest, 
and  is  neither  deterred  from  giving  a  globule  of  the  30th  by 
fear  of  the  incredulous,  or  of  giving  a  drop  of  a  pure  tincture 
out  of  dread  of  the  purist,  and  who  uses  his  liberty  without 
infringing  on  that  of  others.     That  Hahnemann  should  have 
desired  to  promulgate  an  act  of  uniformity  in  our  posology  is 
natural^  seeing  he  was  expected  to  do  so  as  the  head  of  the 
largest  and  most  influential  school  that  has  arisen  since  the 
breaking  up  of  the  Galenic  empire  of  medicine ;   nor  do  I 
find  it  strange  that  in  his  practice,  Hahnemann,  who,  as  a 
flttecesfifol  practitioner,  was  probably  never  equalled,  should  by 
tti*  few  hints  he  drops  in  regard  to  the  doses  he  em^\xyj^. 


84  Lecture  by  Dr.  Russell. 

show  that  he  was  iu  the  habit  of  employing  all  doses,  from 
drops  of  the  pure  tincture  to  portions  of  a  single  globule  of  the 
30th  dilution. 

It  was  natural  that  Ilahnemann,  as  the  founder  of  a  school, 
should  desire  to  introduce  a  certain  degree  of  uniformity  into 
the  practice  of  the  system  he  inaugurated,  for  the  obvious 
reason  which  he  liimself  gives,  that  if  all  used  the  same  dose 
we  should  be  better  able  to  form  a  correct  opinion  as  to  the 
treatment  of  any  case,  and  be  more  secure  of  obtaining  the 
same  results  in  a  similar  circumstance,  than  if  there  were  a 
great  latitude  in  the  amount  of  medicine  employed;  and  also, 
be  it  remembered,  he  fixed  upon  the  30th  dilution  to  put  a 
check  to  what  he  regarded  as  the  extravagancies  of  some  of  his 
disciples,  who  soared  away  into  the  hundredth  and  even 
thousandth  dilution,  and  in  their  devotion  to  these  ghostly 
sublimities  were  in  danger  of  passing  into  a  state  of  such  mys- 
tification as  to  forget  that  the  dose  was,  after  all,  a  matter  of 
only  secondary  importance. 

While  Hahnemann  claimed  for  the  higher  dilutions  their 
rightful  recognition  on  the  ground  of  their  proved  usefulness, 
it  was  hardly  possible  for  him  to  avoid  framing  some  hy- 
pothesis to  account  for  the  extraordinary  development  of 
powers  which  had  never  been  before  revealed.  The  explana- 
tion he  advanced  of  these  surprising  powers  was,  that  they 
were  evoked  or  engendered  by  processes  of  trituration  and  suc- 
cession, and  he  termed  the  result  dynamization.  We  are  not 
in  the  habit  of  scof&ng  at  Newton's  discovery  of  the  analysis  of 
the  sun*s  light  by  the  prism,  because  he  appended  to  it  an 
hypothesis  as  to  the  essential  nature  of  light  which  is  generally 
disallowed ;  and  it  seems  to  me  to  argue  the  opposite  of  a  philo- 
sophical character,  for  anyone  who  believes  in  the  discoveries 
of  Hahnemann  to  attempt  to  hold  up  his  hypothesis  to  ridicule. 
If  we  accept  his  facts,  his  explanation  is  at  least  as  good  as 
any  that  has  hitherto  been  proposed.  How  does  it  happen,  he 
asks,  that  although  the  water  of  this  district  is  highly  cal- 


Lecture  by  Dr.  Riusell.  85 

careous,  it  does  not  cure  diseases  for  which  that  substance  is 
suitable,  and  which  are  cured  by  Calcarea  dynamized  by 
trituration  ?  Here  is  a  question  which  is  yet  tmanswered ;  and 
surely  it  is  more  unphilosophical  to  reject  a  fact  because  its 
discoverer  attached  an  hypothesis  to  it,  than  to  frame  an  ex- 
planation in  accordance  with  the  general  theories  of  the  time 
in  which  the  discoverer  lived,  which  Hahnemann  did.  That 
there  are  latent  "  spiritual "  powers  in  matter  was  a  prevailing 
opinion  long  before  the  time  of  Hahnemann.  It  is  thus  ex- 
pressed by  Lord  Bacon,  "  Let  this  be  laid  for  a  foimdation, 
which  is  most  sure,  that  there  is  in  every  tangible  body  a  spirit 
or  body  pneumatical,  enclosed  and  covered  with  the  tangible 
parts." — Sylva  Sylvarum,  696. 

For  my  own  part,  I  am  disposed  neither  to  admit  nor  to  deny 
the  sufficiency  of  Hahnemann's  hypothesis.  It  is  perhaps  as 
good  as  any  other,  and  merits  careful  consideration  at  our  hands. 
Still  it  is  only  an  hypothesis,  and  does  not  touch  the  validity  of 
the  evidence  in  favour  of  his  great  discoveries — 1st,  that  the 
trae  method  of  curing  diseases  is  to  select  a  remedy  which  pro- 
duces in  the  healthy  body  symptoms  similar  to  those  of  the 
patient  whom  we  are  treating ;  and  2ndly,  that  a  remedy  so 
selected  has  the  power  of  curing  even  in  quantities  so  minute 
as  one  decillionth  of  a  grain  or  drop. 

The  second  proposition,  which  we  may  thus  modify,  "  that 
medicines  have  the  power  of  curing  in  so  great  a  variety  of 
fractions  of  a  drop  or  grain  that  the  particular  fraction  we 
select  from  the  10th  to  the  decillionth  is  of  comparatively 
secondary  consequence,"  holds  true,  however,  only  under  the 
conditions  that  we  choose  a  remedy  strictly  in  accordance  with 
the  maxim  expressed  in  the  first  proposition — the  Homoeopathic 
formula.  If  we  leave  this  narrow  path  traced  out  by  Hahnemann, 
and  attempt  to  discover  specifics  by  any  other  plan,  then  the 
whole  complexion  of  the  question  is  at  once  changed.  To 
illustrate  my  meaning,  let  me  direct  your  attention  to  an 
interesting  paper  which  appeared   in  a  recent  number  of  the 


80  Lecture  hy  Dr.  Russdl 

"  P.riti-jh  Journal  of  Homoeopathy,"  by  Dr.  Eidd,  on  the  treatment 
of  lihiijiis  tuiuoure  of  the  uterus.  Dr.  Badd  observes,  **  The 
hoiiKiopathic  treatment  of  fibrous  tumours  illustrates  the 
r^'O'-ssity  we  liave  to  treat  diseases  not  symptomatically,  but 
rationally.  No  m^  lirine  is  known  to  cause  the  production  of 
fil»ious  tunioiii-s;  and  although  medicines  such  as Sabina, Secale, 
and  Fr-iTiim  Muriaticuni,  are  homaH)patliic  to  the  symptoms 
caused  by  the  tumours,  yet  their  use  is  only  palliative,  and  in 
no  way  curative  of  tlie  disease." 

"  From  the  pathogenetic  effects  of  mercur}-,  it  seems  to  be 
the  nearest  homoeopathic  specific  for  the  disease.  The  primary 
patliogenetic  effect  of  mercury  is  to  cause  an  increase  in  the 
quantity  nf  fibrine  in  the  blood;  also  an  increased  activity  in 
the  fibrous  structure,  and  in  the  fibrous  organs,  such  as  the 
woml).  In  practice  I  liave  found  it  the  most  useful  remedy  in 
the  treatment  of  this  disease."  Dr.  Kidd  then  mentions  that 
he  gives  from  one  to  three  drops  of  the  second  decimal  dilution 
of  CV^rrosive  Sublimate  two  or  three  times  a  day,  it  may  be  for 
many  months.  The  second  decimal  dilution  is  the  100th  of  a 
gniin,  and  three  drops  of  that  three  times  a  day  would  make 
lh(i  daily  quantity  of  this  powerful  salt  of  mercury  taken  by 
tlu»  ])atient  about  tlie  11th  of  a  drop.  In  this  passage  we 
h.'iv(;  two  statements — the  one  is  that  of  a  fact,  and  a  most  im- 
fjortant  fact,^coming  from  a  physician  known  to  have  had  a 
Vi'vy  extensive  experience — viz.,  that  a  given  quantity  of  Cor- 
rosivci  Sublimate  cures  fibrous  tumours  of  the  uterus.  We 
]iav(;  also,  in  explanation  of  the  fact,  the  statement  that  mer- 
cury a(;t8  lioniceoxmthically,  having  the  power  to  increase  the 
fibrin(5  of  the  blood.  While  gratefully  accepting  Dr.  Kidd's 
fact  as  an  important  addition  to  our  resources,  and  trusting 
that  in  the  hands  of  others  this  remedy  may  prove  as  useful 
AH  Ik;  assures  us  it  has  been  in  his,  1  am  compelled  absolutely 
to  r<yecl  his  explanation  of  the  method  of  its  curative  action, 
for  I  liiicl  all  the  authorities  on  the  subject  describe  the  action 
of  mercury  upon  the  blood  as  the  very  reverse  of  what  Dr.  Kidd 


Lectu/re  hy  Dr.  RimdL.  87 

aflinns  it  to  ba  So  feir  ttom  mercuij  piodaciiig  an  excess  of 
fibriiie»  it  causes  a  marked  reduction  in  the  quantity  of  that 
ingredient  of  the  blood.  Dr.  Headland^  in  his  well-known 
prize  essay  on  the  action  of  medicines,  makes  the  following 
observations  in  regard  to  mercury : — "  Mercury  disintegrates  or 
decomposes  the  blood,  and  thus  wastes  the  body.  This  is  the 
systemic  action  of  mercuiy,  on  which  too  much  stress  camiot 
be  laid.  Dr.  Wright  has  analyzed  the  blood  of  patients  under 
mercurial  action.  It  is  materially  changed :  it  contains  more 
water,  and  is  more  prone  to  putrefaction,  than  healthy  blood. 
The  fibriney  albumen,  and  red  globules,  are  diminished  in 
amount."  .  .  .  Wibmer,  who  has  collected  all  the  cases  of 
mercurial  poisoning  which  had  been  published  at  the  time  he 
prepared  his  wonderfully  elaborate  work,  mentions,  as  one  of  the 
characteristic  effects  of  mercury,  "  the  increase  of  the  fluidity 
and  decomposition  of  the  blood,"  and  I  can  find  no  authority 
for  the  statement  that  mercury  at  any  stage  of  its  operation 
increases  the  fibrine.  If  we  are  constrained  to  disallow  Dr. 
Kidd*s  explanation,  are  we  therefore  called  upon  to  reject  his 
facts,  and  the  practical  deduction  to  be  drawn  from  them  ? 
Heaven  forbid  that  we  should  be  possessed  of  so  narrow  a 
spirit.  No.  Let  us  accept  these  and  all  facts  which  add  to  our 
power  of  coping  with  the  multitudinous  forms  of  disease  claim- 
ing our  efforts  to  cure  or  relieve ;  but  let  us  arrange  such  fiacts 
in  their  proper  order,  and  call  them  by  their  proper  name.  If 
mercury  have  the  power  of  curing  fibrous  tumours  in  virtue  of 
its  action  on  the  blood,  then  it  is  by  diminishing  the  fibrine  in 
that  fluid.  Now,  this  action  is  not  pathological,  but  physio- 
logical, and  probably  chemical ;  as  such  it  is  removed  entirely 
out  of  the  conditions  to  which  the  proposition  respecting  the 
dose  of  homoeopathic  medicines  is  applicable.  To  cure  in  this 
way  we  must  use  comparatively  large  quantities,  in  order  that 
th^y  may  produce  the  physiological  effect ;  we  have  no  right 
to  expect  any  action  at  all  in  this  method  from  the  minute 
doses  usually  employed  by  homoeopathic  practitioners.     In  fact, 


8  S  LuUrt  bjf  Dr.  Rusidl. 

« ;  h  '.irf:i  2lx*:  not  homceijpathic  in  any  sense.  Let  this  be 
ci;.-/l:.  .'!y  uii«kT.':too<l,  otherwise  we  shall  find  that  those  who 
atv-:;;;  *  \n  r^-jKirat  th^^rm,  anJ,  ignoring  this  important  tsjcXy  em- 
pl'iV  t;.-:  rri*:<Ii^-imr.s  in  such  doses  as  thev  are  themselves  in  the 
h;ii^i^  ot  jiroh'jribiri;:,  will  l^  grit^vously  disappointed  in  the 
Kvjj!*-.  I>jt  us  recognise  as  a  significant  sign  of  the  times  the 
ri-je  of  Jt  fo nn  of  sj^ecific  therai>eutics  entirely  different  from 
IIoino;o|athy,  and  likely  to  have  a  powerful  influence  upon 
ui^'Amaik: — Vrneficial  as  regards  Allopathy,  to  which  it  will 
naturally  ally  itself,  and  in  my  opinion  detrimental  to  Homoeo- 
patliy,  which  it  will  deprive  of  that  purity  and  certainty  so 
remarkably  in  contrast  with  the  vagueness  and  uncertainty  of 
all  other  methods  hitherto  introduced. 

While  it  may  be  a  cause  of  legitimate  regret  to  see — as  we 
do  in  Gennany — a  large  number  of  men  prefer  the  guidance  of 
I'aracf-lsus  to  that  of  Hahnemann,  in  their  quest  for  specific 
renierlies,  we  are  bound  to  concede  that,  from  their  point  of 
vi(;w,  tli(i  massive  dose  is  jjerfectly  rational     But  we  cannot 
say  HO  much  of  those  who  adopt  the  principles  of  what  I  think 
Dr.  (Jliamhers  calls  conservative  or  constructive  medicine,  and 
aiiempt  to  carry  them  out  with  infinitesimal  doses.    For  exam- 
j)le,  tlidHi  are  some  diseases  in  which  it  is  known  that  iron 
exists  in  (l(jficient   quantity  in   the  blood.    Now,  there  are  two 
plans,  both  rational,  for  treating  patients  so  affected.     The  one 
— the;  constinictive — is  to  administer  iron  in  such  a  form  that 
it  can  l)(^  assimilated  by  tlie  invalid,  and  restore  by  its  chemical 
ac-tion   the  blood  to  its  normal  state.      That  this  is  possible, 
i/4    proved    liy    th(j    rcjsearches    of  the    chemist.      The    other 
])lan   JM  to  (liH(}ov(!r  medicines  which  shall  enable  the  organ- 
ism lo  appropriate}  for  itself  the  iron  wliich  exists  in  abundance 
in  iirMcJcH  of  food,     if  wo  adopt  the  latter  plan,  then  we  should 
nmploy    infiniU'simal   doses;  if  the  former,  we  must  give  the 
irnh   in   tunKihle  (juantities.      To  prescribe  it  in  the  billionths 
of  a  )/niin,  is  as  irrational   as  it  would  be  to  administer  the 
tnillionth  of  a  drop  of  tinoturft  of  senna  to  obtain  an  evacuation 
of  tlu'  howoU. 


Lecture  by  Dr.  Rutsdl.  89 

I  now  come  to  the  consideration  of  the  question  of  the 
administration  of  two  medicines  in  alternation — a  practice 
which  may  be  said  to  have  become  usual,  and  which  is  often 
adopted  even  by  those  who  condemn  it  The  short  time 
at  our  disposal  will  prevent  me  &om  entering  with  any  fulness 
into  this  division  of  the  subject ;  and  I  shall  content  myself 
with  making  a  few  general  observations  on  the  advantages  and 
disadvantages  of  this  plan  of  treatment. 

In  the  first  place,  it  is  so  manifestly  at  variance  with  the 
doctrines  taught  by  Hahnemann,  in  regard  to  the  necessity  of 
coimteracting  one  morbid  dynamic  change,  in  which  he  con- 
sidered a  disease  to  consist,  by  some  one  other  medicinal 
dynamic  action,  and  to  his  belief  of  the  length  of  time  that  a 
single  dose  of  a  medicine  acted,  that  he  could  not  possibly 
regard  the  plan  with  anything  but  repugnance  fix)m  his  theore- 
tical point  of  view.  If  disease  be  one  and  indivisible,  and  if 
its  symptoms  be  but  the  mutterings  of  this  evil  spirit,  and  if, 
on  the  other  hand,  a  medicine  act  as  a  whole — ^giving  a  shock 
to  this  malignant  spirit,  as  knight  charged  knight  in  the 
encounters  of  chivalry — ^then,  with  this  idea  of  morbid  and 
medicinal  action,  it  was  obviously  inconsistent  to  administer 
more  than  one  medicine  at  a  time,  or  to  give  a  second  dose  of 
this  imtil  the  effects  of  the  first  were  exhausted.  But  Hahne- 
mann, besides  being  a  genuine  thinker,  a  profound  excogitator 
of  a  system  derived  from  certain  assumed  axioms,  was  a  man  of 
great  common  sense,  of  large  experience,  and  of  practical  saga- 
city. And  in  medicine,  as  in  politics,  the  most  successful 
administrator  is  he  who,  although  fully  recognising  the  general 
laws  which  philosophers  have  propounded,  yet  adopts  his  mea- 
sures to  the  special  exigencies  of  the  occasion,  even  although 
for  a  time  they  seem  in  violation  of  his  most  cherished  maxims. 
In  medicine,  the  law  of  humanity  is  the  highest  of  all  laws ; 
and  Hahnemann  showed  by  his  practice  that  while  recognising 
the  general  propositions  he  had  laid  down  in  the  "Organon,"  he 
did  not  allow  them  to  interfere  with  his  freedom  of  action  in 


9  0  Lecture  by  Dr.  Russell. 

dealing  with  dangerous  disease.  In  proof  of  this,  we  find  that 
when  he  treated  a  form  of  typhus  fever,  in  the  yeax  1814,  he 
administered  in  alternation  Bryonia  and  Rhus  tox.  In  the 
edition  of  his  Materia  Medica  published  in  1833,  he  mentions, 
in  the  introductory  observations  to  Rhus  tox,  that  the  only 
remedies  which  proved  effectual  were  Rhus  given  in  alternation 
(ab  wechseld)  with  Bryonia.  Nor  does  he  make  any  depreca- 
tory observation  on  the  practice  So  that  even  when  he 
strenuously  maintained  the  theoretical  badness  of  this  method 
of  procedure,  he  does  not  impugn  it  in  an  instance  in  which 
experience  proved  it  to  have  been  useful  It  is  but  fair  to 
observe,  that  although  he  speaks  of  giving  these  medicines 
in  alternation,  yet,  in  the  fuller  history  of  the  epidemic, 
he  describes  the  cure  as  usually  effected  by  a  single  dose, 
first  of  the  one  and  then  of  the  other  medicine. 

If,  however,  we  reject  the  notions  of  Hahnemann,  in  regard 
to  the  essential  nature  of  disease,  as  incompatible  with  the 
modern  pathology  which  has  come  into  existence  since  he  wrote 
his  "  Organon  " — a  pathology  not,  like  that  against  which  he 
inveighs,  founded  upon  conjecture,  but  the  fruit  of  extensive 
and  accurate  observation  on  the  results  of  morbid  changes,  and 
of  careful  inference  therefrom  as  to  the  nature  of  the  actions 
which  produced  these  organic  alterations  in  the  body — are  we 
therefore  justified  in  also  rejecting  his  practical  advice,  never  to 
give  but  one  medicine  at  a  time,  and  never  to  give  a  second 
until  the  operation  of  the  first  has  wholly  exhausted  itseK? 
There  still  remains  another  serious  objection  to  the  administra- 
tion of  medicines  in  alternation,  and  that  is,  that  it  introduces 
such  an  element  of  confusion  into  the  problem  of  what  did 
good  in  any  particular  case  as  in  some  degree  to  vitiate  the 
scientific  value  of  the  result  we  obtain.  If,  in  a  case  of  acute 
rheumatism,  I  prescribe  Aconite  and  Bryonia  alternately,  and 
the  patient  recover,  how  shall  I  determine  whether  the  cure 
were  due  to  the  action  of  the  one  or  of  the  other,  or  of  a 
tertium    quid    compounded  of   both  ?      That  this  is  a  most 


Case  of  Ovariotomy.  91 

serious  objection  must  be  admitted;  and  the  conclusion  I  am 
disposed  to  come'to  is,  that  when  we  adopt  the  system  of  alter- 
nation it  should  be  done  always  under  protest.  The  paramount 
duty  of  the  physician  being  to  cure,  he  is  bound  to  employ  the 
measures  which  seem  to  him  best  suited  for  the  particular  case 
under  treatment.  All  other  considerations  are  secondary  to 
this  irrevocable^  and  immutable  obligation. 


CASE  OF  OVAEIOTOMY. 

Operation  performed  by  Mr.  Ayerst.     Eeported  by 
Mr.  EoBiNSON,  House  Surgeon. 

Harriet  Foster.  Aged  24.  Servant.  Unmarried.  On  May 
6th,  1862,  was  received  as  an  out-patient  under  Mr.  Leadam, 
for  Ovarian  Tumour  of  left  side,  which  she  first  noticed 
eighteen  months  previously.  Fluctuation  was  then  indistinct. 
She  gradually  enlarged,  fluctuation  becoming  more  diffused  and 
distinct,  and  continued  as  an  out-patient  until  Nov.  24.,  when 
she  was  admitted  into  the  Hospital  She  then  measured  36-^ 
inches  in  circumference,  one  inch  below  the  umbilicus. 

Tapping  was  not  had  recourse  to,  as  she  was  considered  a  fair 
subject  for  the  major  operation.  She  complained  of  a  feeling  of 
great  weight  in  the  abdomen,  more  particularly  when  walking  • 
dragging  pain  round  the  hips  ;  much  flatulence ;  sensation  of 
hot  water  passing  down  the  back  ;  giddiness,  dimness  of  sight, 
and  headache ;  excessive  sour  eructations ;  shooting  pain  in  the 
hypogastrium.  Bowels  regular,  but  each  action  is  followed 
by  much  pain,  as  from  piles.  Catamenia  always  regular,  but 
attended  with  great  pain.     There  was  occasional  hysteria. 

From  this  date  (Nov.  24)  to  Dec.  30,  the  general  health 
gradually  improved,  and  it  was  now  decided  to  remove  the 
tumour,  for  which  purpose  she  was  placed  under  Mr.  Ayerst. 


92  Case  of  Ovariotomy, 

At  9  a.in.  the  patient  was  put  under  chlorofonn,  and  an  inci- 
sion made  to  the  extent  of  4^  inches,  in  the  median  line — from  an 
incli  ])f»low  the  umbilicus  to  an  inch  above  the  pubes.  The  tumour 
was  brought  forward,  and  the  separate  cysts  of  which  it  was 
composed  were  tapped  with  the  ovariotomy  trocat.  Some  (the 
larger  cysts)  contained  a  dark-brown-coloured  fluid  of  a  grumous 
consistence ;  others  (the  smaller  ones)  contained  a  thin  straw- 
coloured  fluid.  The  total  quantity  of  fluid  that  came  from  the 
abdomen  was  about  two  gallons — an  ordinary  stable  bucket- 
full.  The  size  of  the  mass  being  thus  much  diminished,  and 
there  being  no  adhesions,  it  was  with  little  difficulty  pulled 
forward.  A  clamp  was  applied  to  the  pedicle,  and  a  ligature 
an  inch  lower  down.  The  tumour  was  then  removed  by  a 
single  stroke  of  the  bistoury.  The  clamp  was  left  outside,  and 
the  edges  of  the  wound  were  brought  together  by  means  of 
large  harelip  needles  and  twisted  sutures.  The  wound  was 
dressed  with  lint  soaked  in  a  calendula  lotion. 

Within  the  envelope  of  the  ovary  were  found  numerous 
small  but  distinctly-formed  cysts,  varying  in  size  from  a  pea 
to  a  hen's  egg,  and  containing  a  pale  straw-coloured  fluid. 

1 1  a.m. — Patient  complains  of  feeling  cold  and  numb  in  the 
lower  extremities ;  slight  numbness  also  in  right  arm.  Great 
tympanitic  distension  in  umbilical  region.     Pulse  84. 

Ordered  beef  tea  and  weak  brandy  and  water.  Temperature 
of  the  room,  65**— 70°  Ft. 

R.  Am.  \  \  4t«  horis. 

1  p.m. — Pulse  112.  Body  quite  warm  and  comfortable; 
numbness  gone ;  tympanitis  continues ;  sharp  pain  at  seat  of 
wound,*  and  slight  nausea.  Several  ounces  of  urine  were  drawn 
off.  This  was  done,  not  because  she  had  any  retention,  but  to 
prevent  unnecessary  motion  of  the  patient. 

6'20  p.m. — Pulse  120.  Stabbing  pain  in  hypogastrium  ; 
passed  a  littje  urine  involuntarily ;  less  tympanitis. 

R.    Aeon.  3  gtt.  j.  h.  s.  s. 


Case  of  Ovariotomy.  93 

Dec.  31,  10*30  a.m. — Nausea;  vomited  a  small  quantity  of 
very  acrid  fluid.     Pulse  112. 

Jan.  Ist^  1863,  9  a.m. — Pulse  120.  Feels  dull  and  low ; 
complains  of  feeling  bilious ;  conjunctiv»  yellow. 

R.  Merc.  sol.  \  i  2'^d»  horis. 

Jan.  2nd,  4  a.m. — ^Pulse  130.  Excessive  clammy  perspira- 
tion. Palms  of  hands  alternately  burning  hot  and  cold ;  feeling 
of  sinking. 

Jan.  3rd,  9  a.m. — Pulse  120.     Has  had  some  hours'  sleep;  ' 
violent  retching  during  the  night ;  stomach  rejects  food. 

12  Noon. — Constant  hiccough;  stomach  rejects  everything; 
tongue  dry  and  brown ;  feels  cold,  but  no  well-marked  rigour. 
Pulse  110. 

R.  Ipec.  \  \  2°^«  horis. 

4  p.m. — ^Foecal  vomiting  to  the  extent  of  at  least  two  pints; 
extreme  chilliness  and  prostration ;  cold  clammy  sweat  all  over 
body. 

R.    Ars.    3    gtt.  j.   2»<^«   horis,   and  after  each  attack  of 
vomiting. 

8  p.m. — Pulse  136.  Feeble;  foecal  vomiting  continues; 
extremities  more  warm. 

R.  Plumb,  carb.  1  gr.  iij.  o.  h.  s. 

11-30.  p.m. — Pulse  130.  Almost  imperceptible;  seems 
much  prostrated.  Vomiting  has  been  much  more  frequent  j 
excessive  jactitation. 

R.  Tinct.  Bell.  gtt.  iij.,  in  Enema. 
R.  Bell.  \  \  tertiis  horis. 
Jan.  4th,  9  a.m. — Foecal  vomiting  less  frequent.     * 
Jan.  4th,  6  p.m. — Seems  getting  worse  every  hour. 
Jan.  4th,  11  p.m. — Pulse  150  ;  quite  thread-like. 

R.  Op.  j.  gtt.  j.,  0.  h.  s. 
Jan.   5th,   6   a.m. — Decidedly   better;    slept   for   an    hour 
during  night. 


94  Com  of  Ovariotomy, 

Jan.  5th,  11  a.m. — Pulse  144;  considerable  foecal  vomit- 
ing, but  less  abdominal  tenderness. 

Jan.  5th,  5*30  p.m. — Clamp  removed  by  Mr.  Ayerst;  she 
is  now  almost  pulseless ;   eyes  within  last  two  hours  have  sunk 
in  lier  liead ;  constant  retching  and  hiccough ;  cold  sweats. 
Ordered  cliampagne,  hot  brandy,  and  beef  tea. 
R.  Ars.  J  J  0.  h.  s. 
Cataplasm  to  abdomen.     Enema. 
Jan.  5  th,  9  p.m. — Seems  rapidly  sinking ;  is  scarcely  able 
to  hiccough ;  is  unconscious  of  what  is  going  on  around  her ; 
extremities  cold ;  tossing  about  in  bed. 

Jan.  6  th,  9  a.m. — Decided  reaction ;  her  extremities  have 
become  warmer ;  slight  glow  on  cheeks ;  tongue  less  brown  and 
hard.  Wound  dressed,  and  pedicle  ligature  removed.  Continue 
Arsen. 

Jan.  6th,  10*30  p.m. — Continues  to  rally;  no  foecal  vomit- 
ing for  twenty-four  hours. 

Jan.  6th,  12  Midnight. — Pulse    150;   very  small;  extreme 
restlessness ;  frequent  and  distressing  hiccough ;  slight  bilious, 
but  not  foecal  vomiting  ;  feels  ineffectual  urgings  to  stool. 
R.  01.  Eecini,  ^gs. 
Sp.  Terebenth,  gtt.  x.  5- 
Pro  Enemate. 
Jan.  7th,  9  a.m. — Had  several  (five  or  six)  evacuations  of 
hard  scybala ;  skin  warm  and  perspiring ;  has  some  swelling 
of  parotid  glands ;  she  fancies  she  caught  cold  from  the  door 
being  left  open. 

R.  Ars.  \  \  4*^  horis. 

Jan.  8  th,  9  a.m. — ^Pulse  112  ;  glandular  swelling  has  in- 
creased so  much  that  she  cannot  open  her  mouth ;  otherwise 
continues  to  improve. 

Jan.  8th,  9*30  p.m. — ^A  profuse  discharge  of  brownish- 
coloured  fluid  has  suddenly  taken  place  from  the  lower  part  of 
the  wound ;  about  a  pint  came  away  at  one  gush ;  she  had 


Case  of  Ovariotomy.  95 

no  pain  with  it,  or  warning  of  its  approach ;  it  had  a  slightly 
foecal  odour. 

Be.  Aeon.  L  s.  8.  (2  doses). 

Jan.  9th,  9  a.m. — Pulse  146  ;  half  a  pint  of  brownish 
foecal-looking  matter  escaped  from  the  wound  during  the  night ; 
she  has  had  no  sleep  ;  abdomen  much  decreased  in  size ;  face, 
gums,  and  mouth,  painfal  and  swollen. 

Jan.  9th,  9  p.m. — ^Pulse  128  ;  bowels  opened  tolerably 
freely  about  mid-day ;  loose  watery  stool ;  a  great  deal  of  brown 
fluid  came  from  wound;  the  wound  gapes  at  lower  part; 
mouth  very  sore  and  troublesome;  has  great  difficulty  in 
swallowing. 

R.  Aeon.  I  I  2""^  horis  (3  doses). 

Jan.  10th,  9  a.m. — Pulse  116,  full;  bowels  slightly  moved; 
intestinal  discharge  from  wound ;  has  had  no  sleep ;  mouth 
very  troublesome;  the  needles  and  ligatures  were  removed, 
and  the  edges  of  the  wound  brought  together  with  adhesive 
plaster ;  takes  a  good  deal  of  nourishment. 

Jan.  16th. — From  last  report  to  this  date  the  symptoms  con- 
tinue much  the  same,  but  indicate  gradual  improvement ;  dis- 
charge from  wound  decreases ;  bowels  act  naturally ;  appetite 
improves,  and  diet  consists  of  good  nourishing  food,  such  as 
chops,  beef  tea,  stout,  wine,  &c.  The  glandular  swellings,  how- 
ever, increase,  and  go  on  to  suppuration.  An  abscess  pointing 
behind  left  ear  was  opened  by  Dr.  Ayerst.  Has  profuse  dis- 
chai^  from  ears. 

Jan.  20th. — ^Vespere ;  trifling  discharge  from  wound  all  day ; 
pudendum  inflamed,  from  excoriating  nature  of  the  discharge; 
bowels  acted  three  times ;  no  pain  in  abdomen. 

Diet  consists  of  beef  tea,  chicken  broth,  arrowroot,  and  port 
wina 

Jan.  22nd. — Has  had  troublesome  cough  last  night,  and  feels 
low  and  weak. 

Be.  Hep.  SuL  1  ^  4*^  horis. 

Jan,  23rd. — Slept  tolerably  well ;  two  natural  motions  \  but 


96  Case  of  Ovariotomy. 

little  discharge  from  wound ;  it  heals  rapidly  at  upper  part ; 
complains  of  plilegm  in  chest ;  tongue  much  cleaner,  but  dry, 
and  slightly  aphthous ;  glandular  swellings  much  diminished ; 
immense  discharge  from  both  ears. 

Continue  Hep.  Sul. 

Feb.  4th. — From  23rd  of  January  to  this  date  she  gradually 
improves,  when  the  report  is  as  follows : — Bowels  acted  largely 
last  night ;  discharge  from  the  wound  for  the  last  three  or 
four  days  has  been  much  less ;  skin  soft  and  cool ;  tongue 
still  slightly  aphthous;  wound,  healed  up  to  one  inch;  a 
conical  piece  of  cork,  covered  with  lint,  soaked  in  calendula 
.  lotion,  was  applied  to  the  wound. 

Continue  Hep.  Sul. 
Vespere  Aeon.  (1  dose). 

Feb.  7th. — ^Pulse  115;  looks  much  better,  and  feels  so; 
discharge  from  left  ear  quite  ceased,  and  from  right  nearly  so ; 
bowels  acted  once ;  plug  removed  to  be  cleaned  and  re-applied. 
Since  its  application  the  stools  have  been  doubled  in  quantity, 
and  much  more  natural  in  appearance.  She  enjoys  much  com- 
fort from  the  plug.      Yesterday,  sat  up  from  12  to  4  o'clock. 

Feb.  13th. — Had  a  good  night's  rest;  no  discharge  from 
the  wound  of  any  kind;  cough  easier;  tongue  clear,  and 
quite  free  from  aphthae ;  appetite  good ;  sits  up  daily. 

From  this  date  she  went  on  steadily  improving,  and  was  dis- 
charged on  the  27th,  cured. 

N.B. — Additional  information  in  regard  to  this  interesting 
subject  will  be  found  in  a  paper  by  Mr.  Leadam,  published  in 
"the  second  volume  of  the  "  Annals." 


^nitals  af  i^t  ^atxtiri. 


THE  POSITIVE  SERVICES  OF  THE  SCHOOL  OF 
HAHNEMANN,  EXEMPLIFIED  IN  THE  TREATMENT 
OF  ACUTE  INFLAMMATORY  DISEASE. 

By  JOHN  OZANNE,  M.D.,  Guernsey. 

Gentlemen, — In  the  summer  of  1860,  a  remarkable  scene 
occurred  at  one  of  the  sittings  of  the  Imperial  Academy  of 
Medicine,  at  Paris. 

In  the  course  of  a  speech,  M.  Malgaigne  used  these  words  : — 
"  Alas  for  the  Medicine  of  the  present  day !  It  forgets  to 
study  disease,  and  looks  to  pathological  anatomy  alone  for  its 
indications !  Without  being  aware  of  it,  its  therapeutics  are 
nothing  more  than  a  jumble  of  contradictions,  the  produce  of 
the  theories  of  all  ages.  Hence  it  has  come  at  last  to  such  a 
point,  as  to  number,  in  one  of  our  hospitals,  fewer  successes 
than  Homoeopathy  has  achieved." 

Here  M.  Barth  exclaimed,  with  energy,  "  That  is  a  falsehood!" 

Numerous  and  tumultuous  protestations  to  the  same  effect 
proceeded  from  other  members. 

M.  Malgaigne  replied,  "  I  hope  you  are  right ;  but  still  my 
statement  may  be  true." 

This  Society  needs  scarcely  to  be  reminded,  that  the  homceo- 
pathic  practice  here  alluded  to,  was  that  of  one  of  its  corre- 
sponding members,  the  late  Dr.  Tessier. 

The  state  of  feeling  depicted  by  the  above  scene,  in  an 
assembly  numbering  among  its  members  the  principal  hospital 
physicians  of  Paris,  had  not  arisen  without  an  adequate  cause. 
VOL.  in.  7 


98  Dr.  Oztnnir  on  the  Positive  Services 

III  tlie  yo«ir  1850,  Dr.  Tessier,  a  man  well  and  honourably 
known  in  tlic  medical  profession;  in  his  earlier  days,  the 
favouriie  pupil  and  friend  of  Dupiiytren ;  and,  subsequently, 
pliy.->ici;in  to  the  hospitals  of  Paris;  published,  in  a  book  on 
rii(if//tnni((  and  Cholera,  the  results  of  his  experience  of  homoe- 
(•pathii!  treatment  in  those  diseases,  at  the  Ste,  Marguerite 
Hospital. 

These  results  were  of  the  most  satisfactory  character,  and 
were  entirely  i)roduced  by  infinitesimals  in  the  form  of  globules. 
The  worst  part  of  the  matter,  however,  was  that  they  could  not 
be  denied.  Neither  could  the  diagnosis  of  the  disease  be  called 
in  question ;  the  cases  having  been  drawn  up  by  internes 
whose  anti-homceopathic  tendencies  rendered  their  testimony 
uninipeacliable  in  the  eyes  of  the  Academicians. 

Although  Dr.  Tessier's  results  were  far  superior  in  pneu- 
monia to  those  obtained  by  a  rigid  adherence  to  the  favourite 
antiphlogistic  treatment  of  the  day,  it  would  not  do  to  admit  the 
superiority  of  Homoeopathy.  The  new  system  was  too  much 
disliked  to  allow  of  such  an  acknowledgment.  It  was  far 
better  to  throw  the  w^hole  blame  on  the  prevailing  method  of 
treatment.  Therefore  M.  VaUeix,  also  one  of  the  physicians 
to  the  Ste,  Marg^ierite  Hospital,  declared  his  conviction  that 
pneumonia  was  a  disease  of  much  less  gravity  than  was  usually 
supposed,  and  would  get  well,  in  general,  of  itself,  if  the  efforts 
of  Nature  were  not  interfered  with.  Others  followed  him,  and  the 
opinion  gained  ground,  that  the  usual  antiphlogistic  treatment 
was  probably  more  hurtful  than  beneficial. 

The  same  thing  occurred  at  Vienna,  but  in  a  higher  de- 
gree. The  results  of  Dr.  Fleischmann's  practice  at  the  Gum- 
pendorf  Hospital,  by  unsettling  the  usual  notions  in  reference 
to  the  treatment  of  inflammation,  led  many  to  the  extremes  of 
scepticism.  Among  the  leaders  of  the  latter  school  at  Vienna, 
I  may  especially  mention  Professor  Skoda,  of  the  General  Hos- 
pital, and  Dr.  Dietl,  of  the  Wieden  (since  then  removed  to 
Crac.ow). 


f>f  the  School  of  Hahnemann.  99 

Skill,  in  Pcuis,  medical  scepticism  has  not,  I  believe,  roachi'd 
such  a  height  as  either  in  Germany  or  in  this  country.  Owiiij^ 
to  the  number  of  rival  professors,  claiming  each  to  l^e  the  leader 
of  a  school  of  his  own,  and  impi*cssin<4  his  views  on  studfjiita 
both  as  a  lecturer  and  as  an  examiner,  H(»ina>opaihy  has  (to  my 
mind  at  least)  hardly  influenced  the  general  tone  of  mind  to 
the  extent  we  might  suppose,  if  w^e  judged  from  the  numl>er  of 
its  professed  adherents.  The  consequence  of  this  state  of  things 
is,  that  while,  in  every-day  life,  all  unite  against  HouKuopathy; 
in  the  scientific  world,  she  takes  her  jJace  as  one  of  the  rival 
doctrines,  attracts  less  notice,  and  does  not  produce  the  same 
extent  of  avowed  scepticism  among  her  antagonists.  Hence, 
her  great  faith  in  the  one  leading  principle — similia  mnilibiis — 
and  in  the  power  of  infinitesimals  administered  in  accordance 
with  that  principle,  does  not  aw^aken  in  the  same  degree  that 
spirit  which  can  alone  arrest  her  progress — ^the  spirit  of 
scepticism. 

In  Edinburgh,  medical  scepticism  in  the  ranks  of  the 
dominant  school  reigns  triumphant,  as  we  shall  see  presently, 
when  we  notice  a  series  of  cases  brought  forward  by  one  of  the 
professors  in  the  University  of  that  city.  In  my  opinion,  the 
great  impetus  given  to  Homoeopathy  in  Edinburgh,  more  than 
twenty  years  ago,  by  Drs.  Francis  Black  and  Eutherfurd  Russell, 
and  subsequently  by  the  conversion  of  Professor  Henderson, 
fully  accoimts  for  the  fact. 

In  London,  the  labours  of  our  colleagues  and  the  establish- 
ment and  continued  existence  of  our  Hospital  has  produced  a 
similar  influence  on  the  minds  of  the  most  advanced  in  the 
dominant  part  of  the  profession. 

It  is  painful  to  think  how  men  of  learning,  endowed  "svith 
every  qualification  requisite  to  form  a  correct  estimate  of  the 
value  of  the  Homoeopathic  principle,  are  prevented  from  enter- 
ing upon  a  systematic  inquiry  into  its  claims  by  the  ignorance 
and  consequent  prejudice  of  the  profession  at  large.  An 
inquiry  of  the  kind,  undei'taken  by  some  of  the  leading  men  in 

*  .T»..  w 


Km  I)i\  Ozanih'  on  the  Posliire  Sn-'viccs 

til.'  (loiuinaiit.  siliool,  and  systcinatioally  earned  out,  during  a 
short  iM-riod  (»!' years,  ^vnuld,^ve  cannot  doubt,  lead  to  a  final  settle- 
ment (»r  the  (p'.cstion  al  issue  Lelwoen  the  two  schools.  Tlieiso- 
li.tctl  iHorls  of  individuals  are  comparatively  of  little  avail  in 
coiiv.rt  iuL^  opjMMicnts,  Ijowover  beneficial  they  may  be  in  confirm- 
iim  Ixliivcrs.  1  have  felt  this  most  keenly  for  several  years 
]);ist,  in  tho  course  of  my  statistical  investigations.  As  an  indi- 
vi(hial  in<iuircr,T  cannot  get  access  to  documents  in  the  possession 
(.r  ]>ul)iic  hospitals,  which  a  commission  invested  with  authority 
by  the  dominant  school  could  easily  procure ;  nor,  had  I  all  the 
most  conchisivti  facts  in  my  x>ossossion,  could  I  obtain  thehear- 
ini;-  which  would  be  readily  awarded  to  public  commissioners. 

r>ut  since  we  cannot  command  on  the  part  of  our  antagonists 
the  atlonlion  which  our  system  deserv^es,  we  must  needs  be 
content  to  plod  on,  working  with  what  materials  may  fall 
witliin  our  reach,  and  addressing  ourselves  to  those  who  are 
suiiieiently  devoid  of  prejudice  to  give  us  an  impartial  hearing. 
I'lie  vital  question  of  the  day  as  regards  the  Hahneman- 
nian  doctrines  and  as  propounded  by  our  adversaries — ^by  the 
Forl^eses,  the  Balfours,  the  Bennetts,  the  Simpsons,  the 
Gairdners — is  this  : — Are  the  cures  observed  in  patients  under 
homceopathic  rule  to  be  ascribed  to  nature  or  to  art  ?  or,  in 
other  words,  are  the  successes  obtained  by  that  mode  of  practice 
2WHitive,  or  negative  ?  While  we  assert  their  positive  character, 
our  adversaries  declare  them  to  be  negative,  or  simply  due  to 
the  absence  of  injudicious  and  injurious  treatment. 

I  might  appeal,  if  I  wished  to  evade  the  principal  difi&culty, 
to  the  broad  fact  that  Homoeopathy  exists  as  a  distinct,  a  well- 
established,  and  a  progressive  school,  represented  by  a  numerous 
and  an  increasing  body  of  medical  men.  But  such  an  argu- 
ment would  not  satisfy  the  doubts  of  a  thoughtful  and  tho- 
roughly candid  inquirer.  The  progress  of  our  school  through- 
out the  civilized  nations  of  the  world,  and  the  numerical 
strength  of  its  members,  would  assuredly  be  an  argument  in 
its  favour  to  a  considerable  extent ;  but  as  the  dominant  party 
still  grftuily  5jwpass  us  in  numbers,  it  is  an  argument  they  are 


of  the  School  of  ILihanannn. 


10] 


everyday  using  agiiinst  us,  ami  wliicli,  innsojiucntly,  wnuM  ]«■ 
of  little  power  in  our  hands.  The  stivn^^tli  of  tlieir  i»o>itiuii 
consists  also  in  their  holding  most  of  tlio  public  in.-jtilutioiis 
which  give  influence  and  authority  io  the  nuulital  profrssifni, 
and  not  in  their  scientific  right  to  lji»M  them.  X«*\vrtlji-h-ss, 
as  they  have  tlux)ughout  made  use  of  th«*.s<'  advantai^'fs,  wiih  thr 
determiaation  to  crush  us  if  possibU*,  and  as  th<»v  Iiavo  not  suc- 
ceeded, it  will  afford  some  presumptive  evitleiici;  of  the  vitality 
of  the  truths  which  Homa^opathy  cmhi-sici-s  to  take  a  glainc  at 
the  statistics  of  our  adherents  in  different  parts  of  tlie  world. 

A. — ^The  present  position  and  devilojMnont  of  the;  houMo- 
pathic  school 

According  to  Catellan*s  "  Annuaire  irom<uoi)athi(iue  **  for  thr 
present  year,  the  accuracy  and  trustworthiness  of  wliich  we  havi* 
every  reason  touphold,^^  the  number  of  medical  men  i)nutisin[^ 
Homoeopathy  in  various  parts  of  the  world  amounts  : — 


In  North  America 

to 

1G55  (No  information  sinci* 

„  the  West  Indies 

» 

32            the  war.) 

„  South  America 

>» 

131 

„  the  British  Isles 

i> 

283 

„  Belgiiun 

>> 

40 

„  Spain 

» 

192 

„  Italy 

» 

lOG 

„  the  Netherlands 

»> 

14 

„  Portugal 

» 

57 

„  Eussia 

» 

vr> 

„  Switzerland 

»> 

37 

„  Parts  of  Asia 

yy 

4^ 

From  these  various 

„  Denmark,  Norw^ay, 

Sweden 

>» 

14 

]>ai*ts  no  precise  in- 

„  Moldo-VaUachia,  Turkey 

a 

5 

-forniati(m  could  he 

„  Poland 

» 

21 

obtained  by  ^lessrs. 

„  Various  other  places 

» 

9. 

Catelhm,  freres. 

„  France 

» 

441 

„  Grermany 

yy 

554 

Total 

3761 

•  There  are,  of  course,  here  as  in  all  works  of  the  kind,  a  small 
number  of  errors;  but  this  does  not  affect  its  general  testimony. 


102  Dr.  Ozanne  on  the  Positive  Services 

Xoto. — In  those  tables  the  United  Kingdom  figures  for  an 
incivaso  of  78  practitioners  over  the  preceding  list  published 
in  18G0. 

As  th<*  total  in  18G0  was  3G15,  these  tables  show  an  increase 
of  14G. 

In  viewing  these  tables,  and  allowing  for  errors,  for  changes  of 
residence,  for  the  continued  insertion  of  the  names  of  persons  de- 
ceased, we  cannot  help  being  struck  by  the  largenumber  of  medical 
men  who  have  adopted  and  put  into  practice  the  system  of  Hahne- 
mann.   Indeed,  the  fact  that  the  new  school  carries  it  out  uniformly, 
in  different  parts  of  the  world,  among  peoples  distant  from  each 
other,  speaking  different  languages,  pix)fessing  different  religions, 
and  often  hostile  to,  or  in  actual  warfare  with  one  another ;  that 
it  increases  notwithstanding  its  opposition  to  all  previously  es- 
tablished notions ;  and  that  it  could  not  exist  as  a  body  of  prac- 
titioners, if  millions  of  people  did  not  adhere  to  it,  even  when 
in  peril  of  their  lives,  speaks  most  strongly  in  favour  of  the 
benefits  conferred  by  its  instrumentality. 

In  the  face  of  evidence  of  that  kind,  how  paltry  is  the 
opposition,  how  miserable  the  pettifogging  of  our  statistical 
adversaries !  Need  we,  with  such  facts,  be  liable  to  the  impu- 
tation that  we  are  attempting  to  build  up  the  homoeopathic 
edifice  upon  a  fictitious  foundation !  Nevertheless,  let  us  glance 
briefly  at  the  scientific  aspect  of  the  question. 

B. — The  statistical  evidence  supporting  the  positive  ser- 
vices of  the  homoeopathic  school,   in  the  treatment  of  acute 

diseases. 

Long  ago  we  heard  it  stated  by  Balfour,  Forbes,  Routh,  Ben- 
nett, Simpson,  Gairdner,  and  others,  that  whatever  favourable 
results  were  observed  under  homoeopathic  treatment,  were  due, 
not  to  any  virtue  our  medication  possessed, — for  it  was  asserted 
to  be  positively  wortliless,  but  to  the  fact  that  pneumonia,  left 
to  itself,  nearly  always  got  weU.      This  has  been  dinned  over 


of  the  School  of  Hahyuinann,  103 

and  over  again  into  our  ears.  First  we  heard  of  Dietl,  who,  at 
the  Wieden  Hospital,  lost  only  7i  per  cent,  of  his  cases ;  and 
then  of  Bennett,  whose  success  was  something  most  startling, 
having  been  obtained  at  the  Edinburgh  Royal  Infimiary,  where 
anything  like  error  or  deceit  was  impossible ;  even  setting  aside 
the  oft  told  tale,  that  regular  practitioners  could  never  have 
any  wish  to  deceive !  More  recently  stiU,  we  heard  of  a  paper 
read  before  a  Medical  Society  at  Edinburgh,  containing  a  large 
series  of  cases,  treated  by  a  method  all  but  dietetic,  and  yet 
presenting  results  of  the  most  admirable  description.  These  re- 
sults having  since  then  been  published  in  Dr.  Bennett's  Lectures 
on  Inflammation,  in  the  Lancet  (May  30,  1863),  we  are  ena- 
bled to  ascertain  their  precise  character,  and  the  nature  of 
the  remedial  measures  applied.  Dr.  Bennett's  statements 
are  so  startling,  that  I  cannot  forbear  transcribing  them 
here. 

"My  practice  is  directed  to  support  the  strength  of  the 
economy,  never  to  weaken  it  in  any  stage  by  antiphlogistics ; 
although,  if  dyspnoea  be  urgent,  cupping  or  a  small  bleeding 
may  be  practised  as  a  palliative,  more  especially  in  bronchial 
or  cardiac  complication.  During  the  febrile  excitement,  mild 
salines  are  administered.  On  the  fourth  and  fifth  day,  when 
the  fever  abates,  good  beef-tea  and  nutrients  are  given ;  and  on 
the  pulse  becoming  soft  or  weak,  from  four  to  eight  ounces  of 
wine  daily.  As  the  period  of  crisis  approaches,  slight  diuretics 
are  given  to  favour  the  excretory  process. 

"The  results  of  this  practice  in  105  cases  of  pneumonia  in 
adults  consecutively  treated  by  me  in  the  clinical  wards  of 
the  Eoyal  Infirmary,  during  the  last  fourteen  years,  are  as 
follow : — 

"KTumber  of  cases,  105.  Deaths,  3  ;  aU  complicated  cases — 
one  of  intestinal  ulceration,  one  of  Bright*s  disease,  and  one  (a 
drunkard)  with  delirium  tremens  and  cerebral  meningitis.  Eatio 
of  deaths,  1  in  35  cases.     Average  age  of  cases,  3I3  years. 


11)4  Di\  Ozannc  on  the  Positive  Services 

Sini^le  iincomplioated  cases  58;  duration  averaged     ISj  days 

J)uul>k'iiiicuinplicatod  cases  19;  „  „  20      „ 

('niiij)li(ated  cases 17;  „  „  ISs    „ 

Uiisali>iactoiy  cases  as  to  1        ^ 

ilurtitioii     j 

Ociitlis 3 


105 

Sul)j5cciucnt  cases,   all  re-  \ 
(.'overed,  mentioned  in  >     10 
a  note  (loc.  cit.  p.  600)  ) 

Total     115  cases,  with  only  3  deaths. 

'*  Average  residence  in  hospital  of  77  uncomplicated  cases  of 
pneumonia  (single  and  double),  was  22^  days.  (This  is  too 
higli:  some  linger  from  weakness,  from  subsequent  attacks  of 
rheumatism,  or  skin  disease.  One  remained  in  a  fortnight  after 
recovery  from  having  no  shoes,  &c.)  " 

"It  has  been  supposed  that  in  consequence  of  this  compara- 
tively small  number  of  cases,  ranging  over  so  long  a  period  as 
fourteen  years,  the  disease  is  rare  in  Edinburgh ;  but  it  should 
be  explained  that  the  clinical  professors  are  on  duty  alter- 
nately ;  and  as  regards  myself,  I  have  never  acted  as  physician 
to  the  Infirmary  more  than  one-half  the  year,  and  in  most 
cases  only  one-third  of  the  year.  Again  it  has  been  supposed, 
from  the  small  mortality,  that  the  cases  there  are  unusually 
slight  and  trivial,  or  that  the  disease  is  not  extensive.  But  it  is 
not  so.  In  Edinburgh  now,  as  formerly,  many,  and  especially 
the  double  cases  of  pneumonia,  have  been  very  severe,  with  great 
dyspncea  and  very  urgent  sjonptoms.  I  have  also  frequently 
X)ointed  out  instances  of  the  pulse  being  hard  and  strong  in 
vigorous  young  men,  in  whom,  however,  most  rapid  recoveries 
were  invariably  observed.  It  should  also  be  noted  that  these 
cases  were  in  no  way  selected,  but  do  not  include  a  few  which 
were  admitted  in  extreynis  at  night,  and  never  seen  by  the  phy- 


of  the  ScJiool  of  HahnematifK  1 05 

sician,  nor  such  as  were  partly  treated  by  other  physicians  in 
the  hospital,  and   for  which  treatment  I  am  not  responsible." 

I  do  not  wish  to  cast  the  least  doubt  upon  the  authenticity 
of  these  cases,  nor  upon  the  correctness  of  the  diagnosis.  At 
the  same  time  I  feel  it  is  not  out  of  place,  in  the  face  of  the  ex- 
traordinary success  of  Dr.  Bennett's  dietetic  treatment,  to  point 
out  some  circumstances  which  throw  a  shadow  over  the  picture, 
and  which  require  that  we  should  reserve  our  conclusions  until 
we  get  full  explanations  regarding  all  that  has  taken  place  at 
the  Eoyal  Infirmary. 

1st.  A  few  cases  admitted  in  extremis  at  night,  and  never 
seen  by  the  physician,  are  not  included. 

This  admission  is  full  of  significance.  The  expression  "  a  few 
cases,"  when  a  total  of  over  115  is  under  consideration,  must 
mean,  one  would  think,  5  or  6,  or  perhaps  7,  or  even  more.  But  Dr. 
Bennett  would  say — It  matters  not  how  many,  since  they  never 
came  under  my  observation.  Granted,  but  they  must  have  been 
seen  by  his  clinical  clerk,  or  some  other  of  his  assistants,  who,  faithful 
to  the  creed  of  the  Professor,  would  not  put  the  patient  under 
the  old-fashioned  antiphlogistic  measures,  but  would  give  "good 
beef-tea  and  nutrients,"  or  perhaps  "  from  four  to  eight  ounces 
of  wine ;"  in  other  words,  the  Professor's  own  treatment  would 
be  brought  to  bear  on  the  moribund.  Such  cases  ought  not  to 
be  excluded ;  at  any  rate,  their  number  ought  to  be  stated,  and 
they  might  thus  be  made  to  constitute  a  separate  category. 

This  argument  acquires  additional  force,  if  we  take  into  con- 
sideration the  tables  of  Dr.  Fleischmann's  Homoeopathic  Hos- 
pital, so  often  quoted  in  controversial  statistics.  I  quote  the  fol- 
lowing from  the  reports  for  the  year  1850  and  1851,  printed 
for  circidation  in  Vienna  : — 

In  1850  there  were  1084  admissions,  consisting  of  cases  of 
all  kinds ;  and  besides  these,  4  patients  brought  in  dying. 

In  1851  there  were  1041  admissions  ;  and  besides  these, 
3  patients  brought  in  dying. 


100  hr.  (fzannc  on  the  Positive  Services 

III  bnth  yoars, — cases  of  all  kinds,  2125  ;  brought  in  dying, 
7;— totiil,  L>i:J2. 

'J'Ih:;  putioiila  in  extronis  thus  constituted  at  Dr.  Fleischmann's 
l-:3U4tli  of  the  whole  numlxjr  of  cases  ;  whereas,  with  Dr.  Ben- 
nett, if  we  put  down  his  morihiuid  at  5,  which  is  the  least  we 
can  d's  frum  his  statement,  they  would  constitute  l-23rdof  the 
whole  number. 

fu  the  Ilomreopathic  Hospital,  1  moribund  to  304  cases  of 
all  kinds;  at  the  Eoyal  Infirmary,  1  moribund  to  23  cases! 
Can  these  statements  of  Dr.  Bennett's  go  forth  unchallenged  ? 

2nd.  The  cases  partly  treated  by  other  physicians  before  Dr. 
Bennett  ought  to  be  cited  with  the  results.  No  one  can  resist 
the  feeling,  on  reading  the  whole  of  the  paper,  that  Dr.  Bennett's 
cases  gave  l)y  far  the  best  results ;  if  so,  how  could  his  colleagues 
be  so  blind  and  negligent  of  their  duties,  as  not  to  perceive  the 
advantages  of  the  dietetic  treatment,  and  apply  it  to  the  patients 
who  fell  into  their  hands  ? 

3rd.  The  average  age  of  the  patients,  3I3  years,  is  a  very  fa- 
vourable one — much  more  favourable  than  in  Tessier's  cases. 

4th.  The  number  of  complicated  cases,  3  in  115,  is  very 
small,  if  we  are  to  believe  the  allegations  of  Dr.  Eouth  in  his 
"  Fallacies." 

With  these  remarks  or  objections  we  must  take  Dr.  Bennett's 
cases  for  what  they  are  worth.  I  have  endeavoured  to  procure 
the  statistics  of  the  Eoyal  Infirmary  since  Dr.  Bennett's  investi- 
gations began,  but  have  been  unable  to  do  so ;  therefore  I  can- 
not compare  them  with  similar  cases  under  the  other  physicians, 
and  under  treatment  not  so  purely  dietetic. 

Statements  such  as  the  above  completely  unsettle  our 
notions  in  reference  to  the  gravity  of  pneumonia,  when  not 
injuriously  interfered  with  by  medical  art.  Yet  we  must  ac- 
cept them,  with  the  reservations  I  have  made,  until  further  facts 
are  brought  forward  to  contradict  them. 

So  far  they  do  not  afifect  our  statistics  of  pneumonia.  The 
course  of  pneumonia  at  Vienna  and  at  Paris  being  very  different 


of  {lie  School  of  Hahnemann,  107 

from  what  it  appears  to  be  at  Edinburgh,  we  must  compare 
allopathic  or  dietetic  results  in  either  of  those  towns  with  tlie 
homoeopathic  in  the  same  place :  thus  our  statistics  will  in  no 
way  be  affected  by  the  Edinburgh  returns. 

But  before  I  proceed  to  ascertain  the  mortality  of  pneumonia  at 
Vienna  or  at  Paris,  under  simple  dietetic  treatment.  I  will  call 
the  attention  of  the  Society  to  a  singular  circumstance,  which 
brings  me  back  to  the  quotation  at  the  head  of  this  paper. 

It  would  seem  that  the  non-gravity  of  pneumonia  had  been 
accepted  by  many  physicians  in  France ;  and  among  the  writers 
on  that  side  of  the  question,  we  may  mention  Dr.  Barthez  and 
Dr.  Bourgeois  (of  Etampes),  besides  the  late  Dr.  VaUeix. 

This  state  of  feeling  was  reflected  in  the  Imperial  Academy. 
Hence,  the  subject  proposed  for  one  of  the  prizes  to  be  com- 
peted for  in  1862  was: — "Expectancy  in  the  treatment  of 
pneumonia." 

It  is  remarkable  that  no  essay  of  a  sufficiently  conclusive 
kind  was  sent  to  the  Academy,  either  from  Edinburgh  or  from 
Vienna,  or  from  the  pen  of  Dr.  Barthez !  The  prize,  therefore, 
was  not  awarded. 

Under  the  circumstances,  we  can  hardly  believe  that  all  the 
supporters  of  the  spontaneous  curability  of  pneumonia,  in  nearly 
all  cases,  are  really  in  good  earnest.  The  suspicion  that  cases 
are  classed  and  weeded  of  patients  in  extremis,  so  as  to  support 
a  favourite  doctrine,  naturally  arises  in  our  minds. 

In  different  localities  there  are  medical  constitutions,  which 
cause  much  variation  in  the  percentages  of  deaths  in  individual 
diseases  and  on  entire  populations. 

Professor  Christison,  in  his  admirable  address  to  the  Associa- 
tion for  the  Promotion  of  Social  Science,  at  one  of  its  meetings 
recently  held  at  Edinburgh,  stated  that  in  Scotland  the  average 
mortality  on  the  whole  population,  for  the  "  seven  years  ending 
with  1861,  was  1  in  48;  whereas,  in  Lower  Austria,  the 
deaths  actually  reach  1  in  21\r ^Lancet,  Oct.  24,  1863. 

Yienna  being  in  Lower  Austria,  we  should,  therefore,  ex^^eci 


1  US  Dr.  Ozanhc  on  the  Positive  Services 

tu  liiid  a  lii^'lier  perctMitage  mortality  tl:an  in  Scotland.  Per- 
hajjs  thi"-  may  explain  to  some  extent  Dr.  Bennett's  astonishing 
succM'Ss.  15iit,  even  here,  we  were  tolil  from  all  sides  that 
l.iM.'UiJiniiia  left  to  nature  was  rarely  a  fatal  disease. 

Dr.  Di«.tl,  in  his  book  intituled  "  Der  Aderlass  in  der 
Luuc^ouentziindung,"  published  in  1849,  declared  his  mortality 
among  i)atients  under  simple  dietetic  treatment  to  be  only  7 
and  4  tenths  per  cent.;  whereas  it  was  20  and  4  tenths  in 
those  who  were  bled,  and  20  and  7  tenths  in  those  who  were 
placed  under  a  course  of  tartarised  antimony.  These  assertions 
startled  us  all  when  they  were  first  made.  But  subsequent  ex- 
perience (under  another  physician,  I  beheve)  greatly  modified 
the  aspect  of  the  matter. 

I  c]^uote  the  follo^ving  facts  from  Dr.  Arthur  Mitchell's  report 
in  the  Ediiiburgh  Medical  Journal  for  November,  1857.  The 
moitality  of  the  same  hospital,  in  1854,  when  "  the  treatment 
was  symptomatic  and  exceedingly  simple,"  averaged,  in  pneu- 
monia, "no  less  than  20  and  7  tenths  per  cent."  So  much  for 
the  boasted  spontaneous  recoveries  in  pneumonia  ! 

Professor  Skoda,  of  the  General  Hospital,  Vienna,  was  said 
to  have  considerably  reduced  his  mortality  in  pneumonia  by 
discontinuing  blood-letting  and  other  active  measures,  and  by 
substituting  simple  dietetic  treatment  as  the  rule.  Now,  what 
are  his  results  ? 

Dr.  ]\Iitchell  (loc.  cit.)  says,  in  a  note  : — "  During  the  same 
year,  1854,  under  Skoda's  treatment,  out  of  53  cases,  31  were 
cured,  8  bettered,  and  14  died.  Of  these  the  disease  lay  13  times 
in  the  left  side,  giving  10  cures,  2  deaths,  and  1  improvement. 
It  occurred  on  the  right  side  19  times,  and  of  these  14  were 
cured,  4  bettered,  and  1  died.  In  12  cases  both  sides 
were  affected,  and  of  these  the  greater  part  died.  '9  cases  were 
complicated  with  extensive  pleuritic  exudation,  and  of  these  1 
was  fully  healed,  2  were  bettered,  and  6  died." 

During  a  series  of  10  years,  ivom.  1847  to  1856,  there  were 
achiiitted  into  the   General  Hospital,  of  which  Skoda's  wards 


of  tlie  School  of  Hahnaiuuni.  1  ()!♦ 

form  apart,  5,909  cases  of  pneumonia;  of  those  1439  died. 
One  death  in  4  and  1  tenth  cases,  or  24  and  4  tenths  deaths 
per  cent. 

It  seems  unaccountable  that  the  simplest  possible  ti-eatment 
an  allopath  could  devise,  should  be  att<3nded  l)y  a  moi-tality  of 
20  or  25  per  cent,  at  Vienna,  and  by  one  of  less  than 
3  per  cent,  at  Edmburgh  (even  if  we  put  down  the  gener.il 
mortality  at  1  in  27  in  Lower  Austria,  and  1  in  48  in 
Scotland). 

But  the  allopathic  mortality  of  Vienna  is  not  greater  than  is 
met  with  at  home  under  the  best  alloimthic  treatment.  In  the 
years  1852-3,  there  were  admitted  into  St.  George's  Hospital, 
London,  91  cases  of  pneumonia — the  deaths  amounted  to  30. 
Out  of  this  number,  46  cases  were  entered  as  complicated — 
22  of  which  died.  To  ascertain  the  mortality  of  the  uncom- 
plicated cases,  we  must  deduct  the  complicated  cases  from  the 
total  of  cases,  and  the  deaths  among  the  complicated  from 
the  total  of  deaths  (as  the  deaths  in  the  uncomplicated  arc  not 
given  in  the  tables).  We  thus  obtain  the  following  residues  for 
the  uncomplicated  cases : — Uncomplicated  cases  45  ;  deaths  8. 
This  gives  1  death  in  5  and  6  tenths  cases,  or  17  and  7  tenths 
per  cent. 

A  mortality  of  1 7  per  cent  among  the  uncomplicated  cases, 
at  St.  George's,  fully  accounts  for  Skoda's  mortality  at  Vienna. 
But  how  does  it  tally  with  Edinburgh  ?  Is  it  that  14  or  15 
per  cent,  are  bled  or  blistered  to  death  at  St.  George's  ?  or  is  it 
that  there  has  been  some  mistake  in  the  books  at  the  Eoyal 
Infirmary? 

It  is  impossible  to  doubt  that  our  Scottish  allopathic  friends 
are  given  to  blundering,  when  they  deal  with  medical  statistics  ; 
especially  if  they  have  before  them  some  disagreeable  homceo- 
pathic  results  which  it  is  urgent  to  explain  away. 

In  the  British  and  Foreign  Medical  Revieiv,  for  October 
1846,  p.  590,  Dr.  Balfour  asserted  that  Skoda's  mortality  was 
6  and  6-10th8  per  cent. ;  and  in  the  next  page  he  informed  us 


1 1  \)  Dr.  Ozannc  on  the  Positive  Servicer 

thai  Skoda  coii-sidiTod  1  in  8  as  his  nsual  proportion  of 
deaths.     L<*t  us  see  what  thcso  assertions  are  worth. 

Al»out  thive  years  ago,  Dr.  Gallavardin,  physician  of  Lyons 
in  France,  j»ul>lished  a  pamphlet,  intituled  "De  TEnseignement 
C'liiii^ue  en  Alleniagne,"  containing  an  account  of  his  visit  to 
th(^  niediral  schools  of  the  Universities  of  Vienna,  Dresden, 
Cracow,  c^'C. 

AiiKjiig  other  questions  he  ascertained  the  results  of  the 
treatment  of  Skoda  and  others  in  pneumonia.    He  found  that — 

1st. — Those  who  had  observed  Skoda's  cases  during  the 
winter  of  185-4-5,  universally  declared  that  he  had  lost  1  out 
of  every  3  cases  of  inflammation  of  the  lungs — say  3  3  per  cent. 

2nd. — A  Vienna  physician  informed  him,  that  at  his  ex- 
amination for  the  doctorate,  Skoda  avowed  that  he  lost  1  out 
of  every  5  of  his  pneumonia  patients — say  20  per  cent. 

3rd. — On  mentioning  this  to  Dr.  Walter,  the  chief  physician 
to  the  General  Hospital  of  Dresden,  and  a  disciple  of  Skoda, 
tlie  Dresden  physician  shook  his  head,  and  said :  "  If  he  only 
loses  20  per  cent,  of  his  pneumonia  cases,  it  is  that  he  has  been 
very  fortunate." 

4th. — The  students  and  physicians  who  attended  the  clinique 
of  Oppolzer,  at  the  Vienna  General  Hospital,  agreed  in  esti- 
mating his  mortality  in  pneumonia  at  1  in  5 — say  20  per  cent. 

It  is  singular  that  the  results  of  Oppolzer,  who  carried  out  a 
moderate  treatment,  but  quite  allopathic,  should  approximate  so 
closely  with  those  of  Dietl,  of  Skoda,  and  of  Walter,  who  belong 
to  the  so-called  physical  school,  and  have  no  faith  in  the  ordi- 
nary remedial  measures  of  the  allopathic  schooL 

These  results  are  of  the  highest  importance,  as  they  clear  the 
way  for  our  homoeopathic  statistics,  so  far  as  Austria  is  con- 
cerned, and  enable  the  statistician  to  estimate  the  positive  and 
undeniable  curative  influence  exerted  by  homoeopathic  remedies 
upon  acute  diseases. 

Let  us  now  inquire  into  the  allopathic  mortality  in  pneu- 
monia at  Paris. 


of  the  School  of  Hahnemann,  111 

I  am  sorry  to  say  I  cannot  procure  any  statistics  of  the 
results  of  simple  dietetic  treatment.  Nor  can  I  give  any  ex- 
tensive allopathic  statistics  since  those  of  GrisoUe.  They  are 
not  to  be  found.  It  would  seem  as  if  our  allopathic  bretliren 
dread  to  publish  the  full  statistics  of  their  hospitals.  But  the 
following  admissions,  taken  from  the  "Gazette  des  Hopitaux" 
of  Paris,  for  the  7th  Feb.,  1863,  and  from  the  "Bulletin  de  la 
Soci^t^  des  HSpitaux,"  and  reprinted  in  the  "Art  M(5dical," 
April,  1863,  are  most  valuable : — 

"  Pneumonia  has  been  frequent  and  severe ;  the  cases  have 
amounted  to  140.  of  which  61  died — more  than  one-third.  In 
children  the  mortality  was  one-half,  and  in  aged  persons  two- 
thirds." 

Granting  that  this  mortality  of  43  per  cent,  was  quite  ex- 
ceptional, which  must  have  been  the  case,  enough  is  left,  if  we 
deduct  the  extra-gravity  of  the  cases,  to  show  that  pneumonia 
is  at  Paris,  as  well  as  at  Vienna,  a  very  serious  disease,  and  one 
frequently  terminating  fataUy. 

Whatever  the  "  Physical  School"  in  Germany,  and  the  die- 
tetic doctors  in  the  United  Kingdom,  may  say,  as  an  argument 
against  ns,  the  results  of  homoeopathic  treatment,  when  con- 
trasted with  the  above,  are  such  as  to  fill  the  bosom  of  every 
honest  disciple  of  Hahnemann  with  justifiable  pride  and  satis- 
faction. 

The  earliest  homoeopathic  researches  of  the  late  Dr.  Tessier, 
when  he  was  as  yet  very  inexperienced  in  the  new  kind  of 
practice,  may  be  safely  compared  with  those  of  Dr.  Bennett. 
Tessier's  published  cases  in  his  work  were  41  in  number,  with 
3  deaths. 

We  have  here  no  mysterious  number  of  patients  in  extremis^ 
no  cases  attended  by  other  physicians  in  the  hospital ;  all  are 
mentioned,  and  their  phenomena  recorded  in  full.  And  yet 
here  we  might  with  more  reason  plead  the  mischief  of  previous 
treatment  than  Dr.  Bennett  can  do  ;  for  some  of  Tessier's  cases 
had  been  bled  before  their  admission — a  proceeding  now  recog- 


112  Dr.  Ozanne  on  the  Positive  Services 

iiisod  as  injurious.     Again,  what  were  the  3  cases  terminating 
in  (loatli  ? 

The  first  was  tliat  of  a  man,  43  years  of  age,  who,  after  the 
liuvcjlution  of  February,  1848,  had  been  exposed  to  difficulties  of 
evciT  kind,  often  suffering  from  want  of  food,  and  whose  con- 
stitution was  broken  down  when  he  was  seized  with  pneumonia. 
He  was  taken  to  the  Hospital  on  the  6th  day  of  the  disease, 
and  first  seen  by  Tessier  on  the  morning  of  the  7th.  His  case 
was  one  of  double  pneumonia,  with  grey  hepatisation  of  the  whole 
of  the  riglit  lung,  and  purulent  effusion  in  the  cavity  of  the  pleura. 

The  second  was  that  of  a  night-man,  60  years  of  age,  who 
had  been  ill  a  week  when  he  was  brought  to  the  Hospital  If 
Dr.  Bennett's  dietetic  treatment  had  been  of  any  service,  this 
man  ought  to  have  recovered,  for  he  kept  quietly  in  bed  at 
home,  abstained  from  food,  and  took  gum  water,  until  he  be- 
came so  bad,  that  he  had  to  be  carried  to  the  Hospital 

The  tliird  case  was  that  of  a  woman,  aged  58,  addicted  to 
drunkenness,  who  was  brought  into  the  Hospital  with  delirium, 
and  unable  to  give  any  account  of  herself.  She  had  purulent 
infiltration  in  the  upper  lobe  of  the  right  lung,  red  hepatisation 
of  the  middle,  and  congestion  of  the  lower. 

At  Vienna,  Dr.  Fleischmann  admitted  in  the  space  of  20 
years,  from  January,  1835,  to  January,  1855,  no  less  than  1058 
pneumonia  cases  into  the  Gumpendorf  Hospital  At  the  latter 
date  there  remained  6  still  under  treatment ;  we  thus  have  1052 
cases,  with  48  deaths, — or  1  death  in  nearly  22  cases,  or 
4' 5  6  per  cent. 

Dr.  Wurmb's  mortality  at  the  Imperial  Homoeopathic  Hos- 
pital, Leopoldstadt,  Vienna,  was  for  a  long  series  of  cases  under 
46  per  cent. 

These  results,  contrasted  with  those  we  have  adduced  as  the 
true  dietetic  or  allopathic  results  at  Vienna,  prove  beyond  a 
doubt,  not  only  the  positive  curative  power  of  homoeopathic  re- 
medies, but  also  their  immense  superiority  over  all  other  known 
means  of  medical  treatment. 


of  the  School  of  Ifahn^nwvn.  1 1 M 

I  think  I  have  proved  by  undcniahle  evidence: — 1st,  Tli;it 
under  any  mode  of  treatment,  pneumonia  is  always  a  disease  of 
considerable  gravity.  2nd,  That  the  superiority  of  the  honuio- 
pathic  results  over  those  of  any  otlier  kind  of  trcatment,  not 
excepting  the  dietetic,  is  so  great,  tliat  no  doubt  can  (ixist  of  tlie 
positive  curative  influence  jjossessed  by  homfoopatliic  remedies, 
in  the  course  and  termination  of  the  most  serious  acute  diseases. 
3rd,  That  this  positive  and  beneficial  inlluence  becomes  most 
conspicuous,  when  all  the  facts  brought  in  by  adverse  statis- 
ticians, to  confuse  the  question,  are  reduced  to  their  proper 
level. 

As  a  final  result  of  tliis  inquir}'-  we  find  that  it  is  not  witli- 
out  reason,  that  so  large  a  body  of  medical  men  throughout  the 
world  have  adopted  Hahnemann's  mode  of  practice,  and  tliat  so 
large  a  portion  of  the  human  race  acknowledges  its  benefits. 

DISCUSSION. 

Mr.  Yeldham  said, — The  great  power  of  Homceopathy  in  con- 
trolling acute  diseases,  and  its  superiority  over  the  allopathic 
plan  of  treatment,  were  facts  so  well  established  amongst  Iloma^)- 
paths,  as  to  require  no  demon stratioiL  Whilst,  therefore,  Dr. 
Eussell  was  readiug  Dr.  Ozanne's  paper,  he  had  j(jtted  down 
what  appeared  to  him  some  of  the  most  evident  reasons  by 
which  that  superiority  might  be  accounted  for.  In  the  first 
place,  the  seizure  of  an  acute  disease  was  commonly  sudden 
and  violent,  and  fell  upon  persons  i)reviously  in  ordinary 
healthy.  The  reactiiDn  against  the  morbific  impression  was 
proportionately  violent,  and  frequently  resulted  in  an  attack 
of  inflammation  of  some  particular  organ — the  lungs,  the  liver, 
the  bowels,  the  throat,  &c.  This  inliammation  tended  to  the 
rapid  destruction  of  the  organ ;  and  if  the  part  attacked  was  a 
vital  part,  to  the  destruction  of  life  also.  Now,  the  ordinary- 
plan  of  treating  these  attacks,  until  a  recent  date,  was  almost 
universally  by  bleeding  and  other  depressing  agents.  The  result 
was  exhaustion  of  the  vital  power  and  death :  the  homoeo- 
pathic plan  of  treatment,  on  the  contrary,  acting  in  conformity 
with  nature's  efforts — ^Kke  helping  like — sustained  the  i)owers  of 
the  system,  and  conducted  the  inflammation  to  a  healthy  issue. 
Another  reason  might  be  found  in  the  fact,  that  the  symptoms 
of  an  acute  disease,  as  well  as  those  of  the  remedy,  were  clearly 
and  distinctly  marked.    The  relationship  between  the  two  was 


1  14  Dr.  Ozannc  on  ihr  Po.'iitive  Seyn'iers 

<lisiiii(  1,  uimI  thuru  was  l»ut  little  dilliculty  in  selecting  the  right 
iviiMtly.  Turn  now  to  chronic  diseases: — ^Although  we  might 
\v\''  liistitiit«'  advantagi'ously  a  con)i)arison  with  the  old  system 
:is  to  tla*  r«'<uhs  of  our  treatment,  the  superiority  was  less 
iii;irk«(l  tlian  in  acute  disordei^s ;  and  lor  these  reasons,  chronic 
«!!•<. 'iis".s  wci'<*  coTiniKjnly  insidious  in  their  accession,  and  slower 
in  tln-ir  ]>roLn*»'Ss — so  insidious  and  slow,  that  the  ^mtient  often 
did  nut  iilt«*n«l  to  them  until  they  had  established  a  firm  hold  on 
tlif  system.  Tliou^di  ai)j)arently  localized  in  their  seat,  they 
wcio  nlutn  hlood  diseases — obscure  in  their  origin  and  nature, 
('nnij)h"cated  and  indistinct  in  their  symptoms.  Under  such 
cir(Ministanc(»s,  it  was  manifestly  very  difficult  to  apply  the 
hninn'ujMiihic  law  with  certainty;  and,  indeed,  in  many  cases  we 
h;nl  jit  ])rcscnt  no  renuMlies  bearing  distinct  and  unmistakeable 
rclntionshij)  to  tlie  disease.  But  where  the  relationship  was  clear 
and  well  marked, —  as,  for  example,  between  chronic  stomach 
allections  and  such  a  medicine  as  Nux  Vomica, — ^then  the  result  of 
our  treatment  was  all  that  could  be  desired.  Out  of  the  sphere 
of  medicine,  moreover,  we,  as  Homceopaths,  w^ere  compelled  to 
resort  to  tlie  same  class  of  auxiliary  means  as  our  Allopathic 
brethren, — care  in  diet,  change  of  air^  change  of  scene,  bathing, 
and  tlie  like.  Although  we  often  cured  chronic  disorders  which 
balllcd  the  old  school,  yet,  for  the  foregoing  amongst  other 
reasons,  our  superiority  was  less  striking  than  in  the  treatment 
of  acute  disorders. 

Dr.  Hughes  said, — I  fully  agree  with  the  author  of  this 
(nooning's  paper  as  to  the  inestimable  service  rendered  by  the 
sclinol  of  Hahnemann  to  the  treatment  of  acute  inflammatory 
diseases.  The  specifics  with  wdiich  Homoeopathy  has  taught  me 
to  combat  these  disorders  are  to  me  a  source  of  daily  delight 
and  thankfulness.  I  do  not,  however,  rate  very  highly  the  value 
of  statistics  as  demonstrative  of  the  success  of  our  treatment  in 
this  direction.  For  statistics  to  prove  anything,  the  phenomena 
whose  sequence  they  classify  must  be  uniform  and  unvarying ; 
and  in  comparisons  made  by  statistics,  every  particular  must  be 
taken  into  account,  and  must  be  identical  on  each  side.  How 
impossible  this  is  in  such  a  subject  as  the  treatment  of  disease, 
it  is  easy  to  conceive.  I  think  it  very  desirable  that,  so  far  as 
statistics  go,  they  should  be  shown  to  be  favourable  to  our  cause ; 
and  therefore,  Dr.  Ozanne  merits  our  sincere  thanks  for  his  past 
and  present  labours  in  this  field.  But  I  believe  that  a  few  well- 
fletailed  cases  of  acute  disease,  homoeopathically  treated  (as,  for 
instance,  those  in  Mr.  Yeldham's  book),  will  do  more  to  enlighten 
the  ignorant  and  convince  the  gainsaying  as  to  the  merits  of  our 
system  than  all  the  statistics  in  the  world.  In  one  particular, 
hr)wever,  I  fear  that  zeal  for  our  cause,  or  imperfect  intbrmation, 


itf  the  SchiMtl  nj  lln}' iV)ivni  ,k .  \  \  Ji 

has  led  Dr.  Ozanue  to  inisunderst.-iinl  tin*  iM-.niiii;  ..f  tli..  -t.i!i.:ics 
he  lias  collected.     I  ivfor  to  tlmsr  (•!'  l>r.  MiiL-lifS   lliim.-!!.  nf 
Edinburgh.     Dr.  Ozaiiiit'  citi*s  tin*  ims.s  nf  tliis  l":i?1'-i:imii  ;is 
instances  of  expectant  or  do-noiliin;,'  tiiatnu'iit,  .ind  uliil*-  Wini- 
dering  at  their  low  rate  (►!'  iiiortality   Z   in    In."-  .  suo._.,..t^  t}i;i? 
pneiiiiionia  miust  he  a  l<*ss  sfiious  diM.'ji>«'  in   KdiiiliU]L:li  than  in 
Vienna,  since  Dietl's  mortality  under  ivxinTiant   triaiiii«nt  was 
ahout  9  per  cent.     lUit  Dr.  IJmnctt  ]nits  Inrtli  liis  (.(-••>  ;•-  illus- 
trating, not  an  exjK'Ctimt,  l»ut  a  .s///7'0/'////'/ ti'-atnun;   mT  arm.- 
disease.     As   soon  as  tlie  jnilsj*  "^nows  ><»rt,  wi-  ;ri\'-  nuiiiiiii-. 
freely,  and  a  moderate  allowance  of  wiiu-.     lli-  nini-Miv.  r  cum- 
mences  his  treatment  hy  the  adniinistratinii  nf  ^mall   tluscs  nf 
Tartar   Emetic,   which    we   know   to   1)«*    a   true    ln'iiKiujiati:!-; 
specific   in  pulmonary  inilaniniati(»n.      Dr.    ru'mnti',  siati-iii-*, 
therefore,    give    no    sujjjjoi-t    to    t'Xjiectancy ;    Init    tiny   >li«»\v 
the  value  of  a  treatment,  tlie  o|)])osite  of  Inwrrinu'    in   a-iit*'! 
disease,  especially  when  conjoined  with  the  admini-tiatinn  nf  a 
specific  homoiopathic  to  the  niorhiil  couditinii.     In   Die-l^  cases 
no  drugs  were  given;  hut  the  i)atient.s  were  ki-pt  uj»oii  low  tliet. 
A  similar  i)lan  as  to  suppoil  seems  to  have  he«'ii  carried  out  l»y 
neischmann,  whose  mortality  was  ahout  o  jjcrcent.     I  cann<it, 
moreover,  agree  with  Dr.  Ozanne  in  the  eoM  and  averted  ^rjmKMi 
he  gives  to  the  expectant  school  of  nK-ilieiue.     1  helieve  it  is  the 
true  stepping-stone  to  Homoiopathy.     The  ]»]iysician  he^^ins  hy 
combating  with  the  most   heroic  moans   the    disnnlejs    of  his 
patients,  until  he  finds  that  the  patients  themselves  too  often 
perish  in  the  midst  of  the  conflict.     Th(i  conii  lenci*  of  inex- 
perience is  broken  down  by  failure,  and  th«,'  lesson  of  humility 
is  taught.    He  acts  less,  and  watches  more;  he  iinds  that  Nature 
will  go  on  working  according  to  her  own  hiws,  if  only  he  will 
leave  her  alone,     llius  he  becomes  "ex])eetant"  in  his  treat- 
ment, and  watches  to  learn  the  various  modes  ol"  working  of  the. 
vis  rrvedicatt^:  naiurcc.     But  if  he  he  a  true  man,  he  will  ikjI 
pause  here.    Man  was  not  made  to  watch  and  to  oIkjv  blind  nature, 
"  vi7icit pareundo,"  indeed,  but  vinri/.     It  is  so  in  every  otlier  art 
based  npon  science;  it  must  be  so  in  medicine;  then  Iloma^o- 
pathy  comes  to  him,  and  holds  out  a  law  of  healing,  obtain(*d  from 
a  careful  observation  of  the  relation  of  drug-action  to  disease. 
Acting  upon  this  law,  drugs  become  to  him  the  instruments 
whereby  in  this,  as  in  every  other  art,  man  asserts  his  mastery 
over  nature.     This  is  the  history  of  the  progi-ess  of  many  a 
mind;  it  is  the  road  by  which  I  myself  travelled  to  my  present 
sure  standing-ground  in  Homoeopathy. 

Dr.  Russell  said  that  he  could  not"^ refrain  from  expressing  the 
satisfaction  which  we  all  felt  at  once  again  addressing  the  Presi- 
dent in  the  chair.     He  (the  President)  had  said  that  it  was  now 

8* 


1  lit  Dr.  Uztfn/u  un  the  Positice  Services 

aliiKxi  twrnty  yoars  sinro  lie  had  first  presided.  For  his  (Dr. 
Ii*ussrir>  part  hi*  saw  no  reason  why  he  (the  President)  should 
iii.t  .M'.ujiy  his  |»n'si*nt  ]»ost  for  t  lie  next  twenty  years.  In  regard 
to  ihf  ]»MjH.T  just  read,  he  agreeil  with  much  tliat  had  fallen  from 
1  )r.  1 1  ii-hfs,  who  indeed  had  anticipated  what  he  (Dr.  Eussell)  had 
iiitriidfil  to  have  saiil,  and  made  it  unnecessar}'  for  him  to  tres- 
]»ass  n]»on  the  time  of  the  Society.  He  would  make  but  one 
observation,  and  it  was  this,  if  we  accept  the  conclusion  of  the 
new  seimol,  as  represented  hy  Dr.  llennett,  then  we  must  come  to 
the  painful  conclusion  that  as  Humoeox>athy  has  done  no  positive 
gnod,  the  smaller  mortality  its  results  display  in  acute  diseases  is 
entirely  owing  to  the  positive  harm  of  allopathic  practice — ^that 
allopathy  is  a  great  deal  worse  than  nothing.  But  if  this  be  so, 
tlH;n  the  various  systems  that  go  under  that  name,  and  which 
followed  each  other  in  such  rapid  succession,  each  new  one  sub- 
verting its  predecessor,  can  have  no  claim  to  our  allegiance  on  the 
ground  of  authority  from  age.  The  practice  of  medicine  as 
]nn'sued  hy  the  expectant  school  may  be  good  or  bad,  but  it  cannot 
claim  any  authority  from  its  greater  antiquity  to  its  self-assumed 
title  (»f  legitimate  medicine.  It  is  as  much  a  usurper  of  the 
sceptre  of  Galen  as  Homoeopathy,  or  even  more  so.  Homoeopathy 
is,  in  fact,  a  much  older  and  more  tried  system  than  the  allopathy 
of  to-day,  which  dates  from  some  ten  years  back.  In  proof  of 
this  position,  he  (Dr.  Piussell)  would  refer  to  the  modem  opinions 
in  regard  to  bleeding  in  apoplexy.  If  for  any  one  particular  mode 
of  treatment  there  was  an  unbroken  accumulation  of  medical 
testimony  from  the  time  of  Galen  to  that  of  Abercromby,  it  was 
that  blood-letting  was  to  be  resorted  to  in  cases  of  congestion  of 
the  brain  and  sanguineous  apoplexy.  Yet  what  does  a  very  able 
and  eminent  practitioner  of  the  present  day — one  of  the  orna- 
meaits  of  the  many  ornaments  of  our  profession — ^Dr.  Radclifife 
— say  upon  this  subject  ?  He  (Dr.  Eussell)  begged  to  read  a 
short  passage  from  Dr.  Kadcliffe's  work  on  Congestion  of  the 
l>rain  and  Ai)Oi)lexy  as  one  out  of  numerous  illustrations  he  might 
have  scilected  : — "  Nay,  it  may  even  be  a  question  whether  blood- 
letting hi\s  any  advantages  at  all.  No  doubt  there  is  enough  of 
authority  in  favour  of  the  lancet,  but  is  there  enough  of  reason?  Is 
tlui  theory  sound  ?  Is  the  practice  sufficiently  encouraging  ?  These 
are  questions  Avhich  will  be  answered  differently  by  different  per- 
sons, and  while  many  will  answer  unhesitatingly  in  the  affirmative, 
others  will  have  doubts  which  will  be  expressed  in  acts  if  not  in 
words.  If  asked,  indeed,  they  may  perhaps  deny  the  existence 
of  their  doubts,  or  speak  as  if  they  had  none;  but  in  actual 
practice,  the  lancet  will  scarcely  be  taken  out  of  its  case.  A  great 
change  indexed  has  already  taken  place,  and  what  the  end  will  be 
it  is  diflicult  to  say.    In  the  meantime  it  would  seem  to  be  better 


of  the  School  of  Hoh n tm ann.  117 

to  err  on  tlie  side  of  doing  too  little  than  on  that  of  dniujr  tm* 
much;  and  on  this  account,  for  njy  own  ]»art,  I  liave  alwav.s 
dispensed  with  the  lancet,  or  any  mode  of  liluod-luttin;,',  in  casi-s 
of  congestion  of  the  bmin  or  apoplexy.  I  liave  done  this  without 
what  may  seem  to  be  good  i-eason ;  indeed,  I  should  find  it 
difficult  to  cite  any  reason,  unless  such  may  he  found  in  the 
change  which  has  come  over  the  habits  of  sncii-ty  and  the  doc- 
trines of  the  scliools.  The  habits  of  society  are  far  more  t»'ni- 
perate  than  they  were  foiinerly,  and  the  ])eojil--*,  in  consri^U'iic**, 
would  seem  to  have  become  less  idethoric  and  less  ti>lrrant  of 
blood-letting.  At  any  rate,  plethora  is  not  a  comnn^n  cliaracter- 
istic  of  patients  now-a-days.  The  doctrines  of  the  schools  are 
also  changed  or  changing  in  one  most  important  point.  Fornnrly, 
every  disease  was  refeiTcd  to  inflammation,  and  the  pathoh»^nst 
was  unhappy  if  he  did  not  discover  the  traces  of  this  lesion  alter 
death ;  now,  many  diseases  are  refeiTed  to  th(j  jirocess  which  is 
the  very  reverse  of  inflammation, — degenemtio.i, — and,  instc:i  I  of 
bleeding,  it  has  been  found  to  be  desirable  to  enricli  the  bIt)od 
and  promote  nutrition.  Nay,  the  idea  of  inflammation  its-lf 
would  seem  to  be  undergomg  a  change  Ijy  which  it  is  beconuMg 
less  fiery  or  inflammatory,  and  more  akin  to  the  i»rocess  wijich 
has  just  been  named.  At  any  rate,  I  have  not  been  able  to  bring 
my  mind  to  order  bleeding  in  any  of  these  cases ;  and,  so  far  as 
I  am  able  to  form  an  opinion  upon  the  practice  which  has  fallen 
to  my  share  up  to  this  time,  I  have  never  had  occasion  to  sui)|>o>:e 
that  abetter  result  would  have  been  brought  about  by  a  dillur:  iit 
line  of  practice."  This  is  certainly  a  remarkable  statement,  (ind 
one  which  shows  how  gi'eat  a  change  has  taken  place  in  so-called 
orthodoxy.  To  return  to  Dr.  Ozanne's  paper,  he  (Dr.  liussell) 
considered  it  a  most  striking  statistical  analysis,  and  one  well  cal- 
culated to  excite  the  attention  of  all  candid  minds,  and  he  trusted 
that  the  learned  author  would  more  frequently  employ  his  i>en 
than  he  had  done  of  late. 

Dr.  Chapman  was  glad  that  Dr.  Ozanne  had  contriLuted  a 
paper,  though  it  was  brief,  and  more  suitable  for  the  reading 
with  the  eye  than  for  the  hearing  with  the  ear.  Our  dis- 
tinguished colleague  excelled  in  many  ways :  he  was  a  man  of 
learning  and  science,  and  withal  an  excellent  practitioner ;  we 
had  no  worthier  nor  better  man  in  our  body.  Dr.  Ozanne  had 
been  a  very  diligent  student,  and  for  years,  in  one  of  the  vciy 
best,  if  not  the  best,  medical  schools  in  the  world — that  of  Paris. 
He  there  acquired  his  taste  for  statistical  science,  of  which  he  is 
now  a  master.  He  pubhshcd  in  the  Homoeopathic  Times  some 
admirable  papers,  in  which  he  minutely  analysed  the  facts  of 
medical  practice  in  some  of  the  most  important  diseases  of  the 
kind  called  acute.     As  a  man  learned  in  the  theories  of  medi- 


lis  l)r.  Ozanttc  un  the  Positive  Services 

(•iiM-.  ln'  ji]ipr('ciatt'3  the  vast  learning,  as  a  philosopher,  the 
snl»liiin'  ]»hilnsn|)hy,  and  as  a  practical  man,  the  admirable 
tlH'r;i|M'Utirs  <)!'  I lahn«'ijiann.  He  was  about  the  last  man  to 
assirt  that  the;  IJaconian  or  ///^/^^r/ar  pi lilosophy  was  exploded, 
or  tliJit  iviiablo  statistius  were  without  value.  He  (Dr.  Chapman) 
cfjii^idiicl  iliat  it  was  far  easier  to  treat  acute  disease  than  chroniCy 
acconliii^r  tn  tlic  law  and  doctrine  of  Hahnemann.  He  hoped 
Dr.  Ozaiiiie  would  ])ublish  in  a  se])arate  fonn  his  valuable  col- 
l»Mtifm  of  statistics,  showing  the  superiority  of  the  homcjeopathic 
iinthod  to  all  (jthci-s  in  the  way  of  drug-healing.  Till  he 
adopt rl  ironi(eo])athy  in  the  year  18-41,  through  the  instrumen- 
tality ni  Dr.  Partridge,  he  (Dr.  Chapman)  was  a  thorough  sceptic 
as  to  drug  tr(.*atment.  He  belie  veil  in  surgery,  but  not  in  medi- 
cine. He  had  long  siniMi  anived  at  the  conclusion,  so  far  as 
(h'ug-healiiig  is  eonctTiied,  it  must  be  Homoeopathy  or  nothing. 
Our  President,  in  his  Annual  Address,  had  given  us  his  ad- 
•jnirable  ntitone  of  what  has  been  done  during  the  session  about 
to  (jlosc!.  When  he  is  able  to  come  among  us,  he  makes  us  feel 
how  (i(jnspicuous  he  is  on  account  of  his  involuntary  absence. 

Dr.  CuKr.MKLL,  after  heartily  concurring  in  the  eulogistic 
remarks  made  by  Dr.  Chapman,  observed  that,  at  this  late  hour, 
it  would  not  be  fair  to  detain  the  members  of  this  Society  with 
lengthy  details  of  eases  in  practical  illustration  of  the  subject  of 
Dr.  Ozanne's  pai)er.  Such  cases  occurred  by  hundreds  in  the 
])racti((».  (jf  eacli  individual  member.  He  woiild,  however,  claim 
the  indulgence  of  the  Society  for  a  concise  narration  of  two  cases 
(each  in  its  own  way)  of  a  character  so  exceptional  as  to  merit  a 
])ul)lic  record.  The  first  he  would  instance  as  a  most  significant 
testimony  to  tlui  rationality  of  the  very  hnite  creation  on  the 
subj(M;t  of  lioma'0])athic  therapeutics.  He  w^ould,  in  fact,  tell 
them  what  a  cat  thought  of  the  homoeopathic  treatment  of 
pneumonia,  and  how  eloquently  this  "so-called''  irratio7tal 
creature  (albcjit  it  S])okc  not)  bad  expressed  its  conviction  of  the 
ellicacy  of  honueo])athic  remedies  in  serious  acute  inflammation. 
The  second  case,  or  rather  terrible  cluster  of  cases — "che  nell 
pensier  rinuiova  la  paura" — of  which  one  of  his  own  children 
AN' as  the  subject,  he  woidd  mention  as  an  instance  of  recovery 
wJiieh  lie  bel  i(.'-ved  to  be  witliout  parallel  in  the  records  of  medicine, 
evcMi  sinec^  the  days  of  Hahnemann.  Some  ten  or  twelve  years 
a;4()  (1  )r.  Chepmell  continued)  he  was  in  the  habit  of  running  out 
of  town  from  the  Saturday  afternoon  to  the  Monday  morning,  and 
(Mijoying  tlie  fresh  air  and  change  of  scene  at  the  country-house 
of  a  friend,  w^henever  his  professional  engagements  admitted  of  a 
little  relaxation.  On  the  occasion  of  one  of  tbese  visits,  almost 
the  lirst    wonis   which  fell  upon   his   ear  were   the  following, 


of  the  Hchool  of  Uahiununin,  1  ID 

addressed  by  his  host,  General ,  to  a  fieiviiiit : — "  J(»h?i,  you 

had  better  shoot  the  cat,  and  put  tho  j)0(»r  brute  out  of  it.^ 
misery."  The  subject  of  this  order,  a  favouriti*  liouso-cat  of  tin* 
family,  lay  at  full  length  on  a  mat  in  a  conna*  of  tin:  i-oom, 
gasping  and  struggling  for  breath,  to  all  a])i)eaninct'  fast  apiu-oacli- 
ing  to  the  term  of  its  "nine  lives."  It  had  rt'niained  for  scvi-ral 
days  in  this  position,  if'fusing  to  (juit  tlu^  spot  or  to  tiikt/  food  of 
any  kind  A  reprieve  was  cheerfully  grautt-d,  on  Dr.  CIh'Ihu  ll's 
volunteering  to  ascertain  whether  a  less  heroic  method  of  tr*at- 
meut  might  not  be  pureued  to  the  advantage  of  all  pailies.  ( )u 
making  an  examination  of  the  chest  from  its  dorsid  asi)'(t, 
extensive  dulness  was  elicit(?d  on  jiercussion,  on  bt)th  sidi-s,  in  a 
nearly  equal  degree;  the  vesicular  breathing  was  inaudiijje;  and 
the  loud  hissing  tubular  ronchiy  neJir  the  base  (»f  the  saxpalrr  on 
either  side,  were  singularly  marked.  In  fact,  there  were  the 
Tinmistakeable  physical  evidences  of  a  very  serious  case  of  double 
pne^cmonia,  which  had  gone  on  unchecked,  and  was  fast  ])roceed- 
ing  to  a  fatal  issue.  Six  drops  of  Phoqyhorus,  :3rd  dilution,  weixi 
forthwith  dissolved  in  six  dessei't-s[)OonfuLs  of  cold  water,  an  I  a 
tea-spoonful  of  the  solution  prescribed  to  be  administered  e\-ery 
hour.  Owing  to  the  patient's  natural  prejudice  against  cold 
water  per  se,  the  admixture  of  a  small  poition  of  milk  was  at 
first  thought  of;  but  as  it  had  already  refused  even  lic^uid  food, 
this  plan  had  to  be  abandoned  :  consequently,  lh(^  administration 
of  the  remedy  presented  a  serious  diiiiculty.  In  this  dilemma  it 
occurred  to  Dr.  Chepmell  that  advantage  might  be  taken  of  the 
animal's  counter-prejudice  for  cleanliness  andcomfoit:  accord- 
ingly, the  dose  was  regularly  dropped  upon  its  coat,  and  as  regu- 
larly licked  up  by  the  patient : — at  first,  with  a  view  to  getting 
rid  of  the  physical  discomfort;  afterwards  (as  the  sc^qucl  of  tlui 
case  will  prove),  from  a  well-grounded  conviction  of  the  remiidial 
virtue  of  the  spilt  fluid.  No  sooner  had  a  cou])le  of  doses  be(»u 
thus  imbibed  than  a  marked  and  steady  cliangci  for  the  better 
took  place;  and,  after  each  successive  repcitition  of  the  remiuly, 
the  oppression  of  the  chest  bcjcame  less  and  less  intense,  so  that 
by  midnight  the  danger  of  suffocation  scjcanod  no  longer  immi- 
nent During  the  remainder  of  the  night  a  member  of  the 
Greneral's  household,  who  had  taken  a  great  interest  in  the  cas", 
continued  the  administration  of  the  medicine  at  intervals  of 
about  two  or  three  hours.  Throughout  the  next  day  (Sunday) 
the  .improvement  continued;  the  cough  was  loos(.'r,  and  the 
breathing  less  laboured;  the  animal  lu^gan  to  take  li([ui(l  food 
in  the  shape  of  mUk  and  water,  and  to  move  about  a  little, 
although  still,  for  the  most  part,  a  fixture  to  its  mat.  A  cor- 
responding improvement  had  taken  j)lace  in  the  physical  signs ; 
for,  although  the  dulness  on  percussion  was  still  extensive,  the 


120  Dr,  Ozannc  on  the  Positive  SerHccs 

intensity  of  the  tuluilar  lircatliing  had  much  diminished,  and 
soil  ciTjiitiint  I'alrs  ^Vl•lv  audible  at  the  extremities  of  both  lungs. 
I'lidcr  tlu'st'  fsivnurabli'  circunistanoes,  tlie  intervals  between  the 
dnsi's  wen*  prolon^^i'd  to  three  and  four  hours  during  the  day,  and 
ii(»  niiMlicinr  was  oxliibited  from  midnight  until  the  next  day.     By 
!M(»uday  morning,  a  fui-tlirr  and  marked  improvement  had  taken 
]»lac('.     Tliii  animal  was  beginning  to  move  about  more  briskly, 
anil  had  i»artaken  of  bread  and  milk.     On  taking  leave  of  the 
family,  Dr.  ClieinnoU  left  a  supply  of  P/w&^t?)^^?'//^,  with  instruc- 
tions tor  its  eontinued  exhi]»ition,  until  his  return  on  the  follow- 
ing Saturday  afternoon.     On  renewing  his  visit  (on  the  Saturday) 
liL   leiirned  from  his  host  that  his  feline  friend  had,  for  the  two 
previous  days,  been  roaming  about  the  garden,  engaged  in  its 
favourite  i)ursuit  of  watching  the  spaiTOWS,  and  from  that  time 
had  "voluntarily  given  up  the  treatment."     On  asking  for  an 
explanation  of  what  he  mi»ant  by  the  expression  "  voluntarily 
giving  up  tlut  treatment,"  the  General  assured  Dr.  Chepmell  that 
h(^  was  not  using  the  phras(»-  in  a  rhetorical  sense,  and  instanced 
as  a  proof  of  the  oat's  wonderful  rationality  on  the  subject,  the  fact 
that,  in  the  course  of  the  i)revious  Monday,  the  young  lady  who 
had  been  in  the  habit  of  administering  the  remedy  in  the  manner 
already  mentioned,  having  forgotten  her  charge,  the  animal  of 
its  own  accord  caine,  and,  by  the  pecidiar  way  in  which  it 
attracted  attention,  contrived  to  remind  her  of  the   omission. 
Thereupon,  it  occurred  to  her,  that  she  would  test  pussy's  real 
intentions  by  presenting  her  with  a  spoonful  of  the  remedial 
so  1 11 1  i on.     The  cat,  withcnit  the  slightest  hesitation,  at  once  lapped 
up  the  medicine  from  the  spoon,  and  then  returned  to  its  mat. 
From  that  time  forward  until  the  day  when  it  "  voluntarily  gave 
up  the  treatment,"  as  no  longer  applicable  to  a  state  of  health, 
the  cat  having  become  its  own  physician,  would  come  of  its  own 
accord,  as  if  by  a  tacit  agreement  (at  first,  at  intervals  of  four 
or  five ;    then,    as    convalescence  advanced,    of    six  or  seven 
hours),  and  diink  the  medicine  out  of  the  spoon  from  the  hand 
of  its  fair  mistress,  so  superior  had  the  feline  mind  risen  to  tlie 
prejudices  of  mere  physical  instinct.     Before  quitting  liis  hos- 
pitable friends.  Dr.  Chepmell  had  an  opportunity  of  ascertaining 
the   completeness  of  the  cure  by  a  physical  examination,  to 
which  his  former  patient,  who  was,  in  truth,  a  very  gentle  and 
tame  ci-eature,  subnntted  with  becoming  grace.     With  regard 
to  the    second   case  (that   of   his   own   child),  Dr.   Chepmell 
remarked  that,  although  his  nerve  had  never  failed  him  in  so 
far  as  the  treatment   was  concerned,  he  had   at  the   time  no 
heart  for  scientifically  recording  all  its  frightful  complications. 
In  fact,  during  u])wards  of  six  months  of  agonising  suspense, 
he  hardly  dared  to  believe  in  the  possibility  of  a  favourable 


(if  tlvt  School  of  HahmmtiniL  121 

issue,  with  such  fearful    rapidity   had    each    Ruccossivc*  hlnw 
been  struck,  hefore  the  cumuhitivu  Kluuks  cif  ])nMMMliii<r  attarks 
could  be  recovei'cd  from  l»y  the  sluiltcnMl  ci»nsiituti«iii  nl'  tin- 
little   patient.     He  would,  luiwovrr,  j^ivt.*   a    suiiiniarv  of  this 
great  triumph   of  the   healinf:r   art,  wliith   In*   Ih-Ui'VimI   to   U^ 
without  a  parallel  in  the    annals  nt*  iinMlirinr,  and  l'«»r  w liiili 
he  would  ever  be  grateful  to  the  nu'iiiur}*  nf  that  ^'icat  ami  "loiid 
man,  whose  genius  lighted  fur  all  tinu-  that  tlu-raiM'Utic  InMi-on 
by  which,  in  the  darkest  night  of  ]»at]i<ilc»gical  uncertainty,  the 
foundering  vessel  of  mortal  life  may  yet  be  stifi-ed   intu  the 
calm  channels  of  convalescenee.  About  the  bi-ginnin^  nf  l-'t-hniary 
1861,  his  daughter,  then  a  imiviously  ln-althy  chiM  i»f  r»  yrars  of 
age,  had  an  attack  of  continued  fever,  which,  almost  from  the 
first,  assumed  a  ty|.)hoid  form,  and  which,  having  seriously  en- 
dangered her  life,  left  her,  after  a  duration  of  between  >ix  and 
seven  weeks,  in   al>out   as   unfavourable  a  eomliiiMn  as  mnld 
well  be  imagined  for  a  struggle  with  any  fresh  niorbitic  inlluenco, 
a  very  wreck  of  herself,  weak  and  emaciated  to  a  d«'^M"e(.*  that 
would  have  rendered  him  anxious  for  the  fulun*,  had  no  n«  w 
complication  ensued.   As  a  measure  of  llie  virulenct;  of  the  fi.vcr, 
he  might  instance  the  hideous  disfigurement  of  the  u]»|)(r  lip 
(which  continued  for  many  months,  an<l  of  which  slight  ciea- 
trices  remain  to  this  day),  caused  by  several  extensive  fissures 
right  through  the  skin  and  mucous  membrane,  consequent  ui»on 
the  excessive  haemon*hagic  exudations  of  the  mouth  and  nostrils, 
at  which  the  child  was  constantly  picking,  when  the  ty]ihoid 
symptoms  were  at  the  worst;    he  might  also  add  the  occasional 
suppression  of  the  urine,  the  troublesome  b(?d-sores,  and  the 
tendency  to  colliquative  diarrhoea,  to  say  nothing  of  that  disposi- 
tion to  congestive  bronchial  cataiTh  which  afterwards  became  so 
formidable  an  element  of  futm'e  danger.     In  so  unsatisfactory 
a  manner  had  convalescence  commenced  that  it  occurretl  to  1  )r. 
Chepmell,  who  at  the  time  was  attending  a  case  of  measles,  that 
an  attack  of  this  exanthem  was  only  wanting  to  insure  a  I'atal 
issue.     Within  a  few  days  of  this  unwelcome  thought,  the  eru])- 
tion  of  measles,  ushered  in  by  fever  and  delirium,   mac  hi   its 
appearance.      The  eruption,  which  at  first  was  very  full  and 
confluent,  suddenly  struck  in  on  the  second  day  its  retrocession 
being  immediately  followed  by  symptoms  of  cerel')ral  and  pul- 
monary congestion,  with  coldness  of  the  extremities.     After  the 
timely  exhibition  of  Cuprum  Aceticum  and  BciUadonna  at  short 
intervals,  the  eruption  again   reappeared,  althougli   in   a  less 
satisfactory  manner,  and  simultaneously  a  suppurative  inilamma- 
tion  of  the  eyelids  (which  for  ten  days  effectually  blinded  the 
patient)  completely  relieved  the  brain,  and  in  a  less  degree  the 
lungs.     The  exanthem  continued  to  run  its  course  imchecked. 


122  Dr.  Ozanne  on  ttte  Positive  Services 

and  had  no  sooner  faded  away  than  the  smouldering  mischief] 
the  dutat  hurst  into  a  flame,  and  acute  Broncho-pneumonia,  e: 
tcn.siv(;ly  aifecting  hoth  lungs,  in  about  an  equal  degree  (in  whic 
the  phniritic  membranes  became  ulthnately  involved),  ensue* 
0\vin;j[  to  the  ])rostration  of  tlie  vital  powers,  only  a  partial  r< 
covcry  luul  taken  place  and  a  tlireateiiing  state  of  sub-acu1 
iiiflannnation  had  remained  behind,  when,  at  the  end  of  anotlu 
fortniglit,  by  way  of  climax,  the  symptoms  of  whooping-coug 
werii  su])eradded.  From  a  once  comely  child  she  was  now  r< 
duc(3d  to  a  mere  living  skeleton,  a  tmly  hideous  and  pitiabl 
oljjcct  to  behold,  as  though  she  had  put  on  the  withered  feature 
of  decrepit  old  age.  The  moral  irritability  which  accompanie 
this  ])hysical  dilapidation  was  not  less  distressing  to  witnesi 
Notwithstanding  the  frightful  struggles  with  the  wliooping-cougl 
attended  as  they  often  were  with  imminent  danger  of  suffocatioj 
re])eated  day  by  day  and  night  after  night,  and  the  frequer 
rekindling  of  the  acute  Broncho-pneiunonic  inflammation,  on  th 
sliglitest  unfavoumble  atmospheric  change,  during  that  tryin 
spring  of  18G1,  she  had  rallied  sufficiently  by  the  beginning  c 
June  to  justify  the  risk  of  her  careful  removal  to  the  country 
at  a  short  distance  from  town.  Evfm  then,  he  himself  had  bu 
slender  ho])e — ^whilst  those  of  Ids  intimate  medical  friends  wh 
had  watched  the  case,  as  they  afterwards  confessed,  had  eve: 
less — of  lier  idtimate  recovery  ;  for  there  was  still  a  considei 
able  amount  of  condensation  of  the  pulmonary  parenchym 
on  both  sides;  much  sub-acute  bronchial  irritation  in  bot 
liuigs,  and  more  or  less  serous  effusion  in  both  cavities,  moi 
especially  in  the  left :  moreover,  the  emaciation  had  not  bee 
recovered  from,  she  was  worn  out  by  hectic  fever,  and  unabl 
to  stand  from  weakness.  Under  the  reviving  influence  of  th 
pure  mild  atmosphere  of  Forest  Hill  and  Sydenham  (for  she  W8 
regularly  carrietl  out  into  the  open  air  on  fine  sunny  days),  sh 
rallied  slowly  yet  steadily,  regained  her  appetite,  and  the  ches 
affection  became  less  urgent  ;  so  that  by  the  beginning  < 
8e])t(Mnl)('r,  when  a  change  to  the  sea-side  was  thought  desirabl 
she  had  gained  a  little  flesh  and  was  able,  with  assistanc< 
to  walk  a  short  distance.  After  going  back  to  town  for 
week,  she  was  taken  to  Guernsey,  where  she  remained  unt 
the  end  of  October.  During  her  stay,  she  was  under  the  imme 
diate  care  of  her  talented  uncle.  Dr.  Ozanne,  who  successfull 
brought  her  through  two  serious  relapses  of  acute  Bronchc 
pncjumonia.  Although,  on  her  return  to  London,  the  aifectio 
of  the  lungs  was  still  very  serious,  some  ground  had  been  gaine 
by  her  rijsidence  in  Guernsey.  Tlie  whooping-cough  was  le* 
troubh^sonie,  and  she  had  i)icked  up  a  little  more  flesh.  Durin 
the  winter  of  1861  to  1862,  the  improvement  was  remarkabl 


of  th€  Sf'hool  ttf  II, I h  I},  f„ ,1  „/,.  \  -j; ; 

steady;  and,  iiotwith.staii(liii*(  tMrasimial  ilin-at.-niiiL'^  «.!' nn.  u.-i 
pulmonic  conf;f\stion,  tlirn*  \vi*r«»  in)  sfrimis  rila|i-i-^.  Th,.  ,  |,ii,| 
was,  of  necessity,  almost  entirely  cnn tin i« I  tn  tht-  limi-.-.  takiiii» 
an  airing  in  the  curria^^n*  cm  «'xi«-|»tiiiiial»ly  lim-  (Ia\-.  \\\  ih.. 
end  of  the  winter,  however,  tin*  litll*-  |«ali«iil  liail  r.LMiiJ««l  in  a 
measure  her  ijlumimcss  and  ^^ood  l«M.k>:  tli**  liniL:>  w.-n-  nnr,. 
more  iXTvious  to  the  air;  tin*  hertir  li-vi-r  had  r.-.i-^.-d  ;  an>l  all 
that  remamed  of  tin*  fnrniiilahli'  array  ^\)i  clu-.!  >\  inpioni-  \\a-<  a 
clmmic  bi-onchial  ratarrli,  ehi«*lly  eniiiin»d  In  tli"  i-li  liniLr.  and 
from  which  the  rij^ht  was  eoniiiarativcly  Iiim-.  niirin;:  lii"  -|"ii!ij. 
and  summer  of  18(3:i  sin*  was  alil«'  tn  tak'-  a  lair  aiiiMiin!  ni 
walking  exei^cise  on  every  fine  day;  and.  wiili  tin-  i\. .  |.ii..ii  mI 
one  or  two  ]')an)xysnis  on  first  ;4"ttin^'  into  lu-d  at  ni-hi  an-l  nn 
awaking  in  the  morninjr,  the  cough  did  not  ironlilf  ler  Inr  day^ 
together:  her  a])[)elite  was  excellent,  an«l  ln-r  ^'-n'ral  ln-al!li  ni«»'t 
satisfactor}\  On  her  return  to  (luernsiy  in  lIi--  aulunm.  Dr. 
Ozanne  was  struck  with  aniazenn-nt  at  tin*  evid»'nr»-s  uf  li.-i 
recovery;  for,  when  ho  had  taken  leave  nf  Inr  tin.*  yi-ar  iM-tni-.-, 
he  scarcely  believed  the  resolutifjn  ol'  so  mmli  or;:ani«.'  misc-hii.t 
in  the  lungs  possible  to  a  constitution  so  sliatl«ivd.  II.- tii.-n 
thought  that  she  had  only  survived  that  inmnMise  ani<»mii  of 
acute  disease,  eventually  to  become  the  victim  of  ]iuhii«»nary 
consumption.  A  residence  of  some  months  on  that  iMautiluI 
TAncresse  Common,  where  she  daily  took  an  amount  of  ex.Mvis**  to 
whichmanyan  adult  wouM  have  lK,'en  unequal,  so  coiii|iht»ly  re- 
stored her,  that  from  that  time  all  anxi<'ty  eeasiMl  on  In-r  aee.nint. 
He  might  add,  that,  at  the  close  of  that  same  autumn,  <linrily 
after  she  reached  honn»,  she  had  an  attack  of  srarlaiin:i.  fmni 
which  she  recovered  most  satisfactorily,  lie  would  now  ;^ivi'  an 
abstract  of  the  reuKMlial  treatment  pursuiMl  with  su<'h  a  liajij)y 
result.  The  ty])hoid  f(»ver  was  chi(?fly  treated  with  Aeonit.,  iiry.. 
Khus  Tox.  Cantliaris.,  r»eHad.,  rhos])h.,  IMiosj»h.  Acid.,  Arsen.  and 
Sulph.;themeasles,withAcou.,rulsat.,(Jupr.  Acet.,  r>ella<l.,Pho<j»li., 
Bry.  and  Suljdi. ;  the  pneumonic  inllammaticui  and  it-;  nunn  rous 
relapses,  with  Aeonit.,  Thosph.,  Tai-t.  Kmet.,  and  Sulph. ;  the 
whooping-cough,  with  I>ellad.,  I])ecac.,  He}).  Sul])h.,and  (.'arb.  An.  ; 
and  the  scarlatina  with  BellaiL  AVith  the  exce])tion  of  Siilph., 
Arsen.,  and  Carl).  An.,  which  were  also  exhil)ited  from  time  to 
time  in  the  30th  and  20Utli  attenuations,  when  there  was  exces- 
sive prostration  of  the  vital  powers,  and  of  riK»si)h.,  Tart.  Emet., 
Sulpli.,  and  Aeonit,  which  were  also  administered  in  the  I»rd, 
4tli, and  5tli  decimal  attenuations,  whiMi  i\\it  inllammatit»nsof  thii 
lungs  were  very  acute,  the  3rd  cent(^sinlal  or  <)th  decimal  were. 
the  attenuations  prescribed.  To  rhosi»h.  and  Tart.  Kmetic,  abov«; 
all  the  other  remedies  (which,  nevertludess,  fully  answered  their 


124  Dr,  Ozanne  on  tJie  Positive  Servicer 

respoctivc  imlications),  and  to  single  closes  of  1  or  2  drops  of 
»SuIi)h.  30tli  or  200th,  did  the  patient  owe  her  life  over  and  over 
agiiin,  when  Dr.  Chepmell  thought  that  she  could  not  outlive  the 
night,  whotlier  from  the  intensity  of  the  relapses  of  acute  inflam- 
mation or  from  the  consequent  vital  prostration.  So  great  was  the 
chikl's  own  appreciation  of  tlie  action  of  these  remedies,  that  she 
would  lierself  imerringly  suggest  their  exhibition  (aft<3r  she  had 
got  to  know  their  names)  from  her  own  feelings.  A  diet  gradually 
proportioned  to  the  powers  of  assimilation,  a  cautious  use  of 
dietetic  stimidants  (which  at  no  time  exceeded  6  teaspoonfuls  of 
})ort  wine,  and  2  claret-glasses  of  Dublin  stout,  in  the  twenty-four 
hours),  a  teaspoonful  of  Cod  Liver  Oil  (as  soon  as  the  stomach 
couhl  boar  it),  and  cliange  of  air,  especially  at  the  sea-side,  were 
restorative  elements  of  the  highest  importance. 

The  Pkesidext,  in  summing  up,  remarked,  that  the  paper 
read  to-night  Avas  highly  interesting  and  important,  and  quite 
bore  out  and  justified  the  remark  made  by  him  in  an  earlier 
part  of  the   evening,   in  his   acUlress   from  the   chair,   that   a 
paper  l)y  Dr.  Ozamie  Avould  be  sure  to  be  replete  with  practical 
information,  and  give  evidence  of  careful  investigation.     The 
author  had  already  established  his  reputation  as  an  accurate 
collector  and  lucid  arranger  of  statistical  facts,  which,  when  they 
were  honestly  dealt  with  and  conscientiously  recorded,   must 
always  carry  great  weight  of  evidence  to   all  inquiring  and 
earnest  minds.     He  agreed  with  Mr.  Yeldliam  in  his  observa- 
tions about  acute  diseases,  and,  indeed,  all  experienced  homoeo- 
pathic i^ractitioners  were  unanimous  in  their  opinion  as  to  our 
mode  of  treatment  being  much  more  successful  in  acute  diseases 
than  in  chronic,  and  that  if  they  wished  to  carry  conviction  into 
the  mind  of  an  enlightened  and  experienced  physician  of  the 
prevailing  school,  they  would  much  prefer  showing  him  their 
treatment  of  acutely  inflammatory  cases  than  those  of  a  less 
urgent   nature  and  acute  character;  and  if  the  inquirer  came 
with  an  earnest  desire  to  seek  the  truth,  and  brought  a  mind 
unbiassed  to  the  investigation,  he  coidd  not  fail  to  perceive  the 
power  of  Homoeopathy  to  combat  acute  disease  in  its  various 
forms.     He  (Dr.  Quin)  also  agreed  with  Mr.  Yeldham  respecting 
the  greater  difficulty  attending  the  treatment  of  chronic  diseases, 
if  it  were  wished  to  impress  our  opponents  of  the  old  school 
favourably  with  respect  to  the  advantages  of  Homoeopathy ;  but 
even  here,  if  the  inquirer  carried  on  his  researches  patiently  and 
in  good  faith,  he  would  find  that  he  had  entered  on  a  wide  field, 
in  which  means  were  at  his  disposal  to  treat  successfully  many 
cases  which  had  previously  baffled  his  attempts  to  cure  by  the 
ordinary  method.    In  both  schools,  it  was  universally  acknow- 
ledged, that  chronic  diseases  were  more  difficult  to  cure  than 


of  the  School  of  Hahneviann,  l25 

acute;  but  wheu  an  allopathic  physician  saw  the  siiccoss- 
fiil  treatment  of  several  severe  and  well-niarkcHl  chronic  cases  hy 
Homoeopathy,  it  had  a  greater  efTect  often  upon  him  than  the  cure 
of  a  similar  number  of  acute  cases,  because  he  had  gi-eater  dilU- 
culty  in  the  former  than  in  the  latter,  to  attribute  them  to  a 
spontaneous  solution-  He  (Dr.  Quiii)  was  inclineil  to  go  with 
Dr.  Hughes  to  a  certain  extent  in  his  strictures  on  the  utility 
of  some  statistics  in  proving  the  superiority  of  one  system  of 
treatment  over  the  other,  unless  the  circumstances  under  which 
both  treatments  were  carried  on  were  exactly  identical,  and  the 
cases  similar  in  gravity  ;  but  these  objections  fall  to  the  gromid 
when  the  statistics  were  gathered  from  the  Hospital  practice  of 
a  physician  like  Dr.  Tessier,  who  compared  the  results  of  his 
own  ti-eatment  in  his  own  wards  under  the  two  different  modes 
of  treatment — ^the  old  and  the  new ;  and  let  it  be  bonie  in  mind 
that,  at  the  time  of  his  experiments,  he  was  a  most  skilful, 
accomplished,  and  experienced  physician  in  the  mode  of  ti-eat- 
ment  of  the  old  school,  whilst  he  was  but  a  recent  convert  to, 
and  inexperienced  in,  homoeopathic  practica  Similar  value 
attached  itself  to  the  statistics  of  his  (Dr.  Quin's)  friends,  the 
late  Dr.  Mabit,  Professor  of  Pathology  and  Physician  to  the 
Hotel  Dieu,  Bordeaux,  and  the  late  Dr.  de  Horatiis,  Professor 
of  the  University  of  Naples,  and  Physician-in-chief  to  the 
Military  Hospital,  both  of  whom  had  published  the  results  of 
their  experiments  in  both  their  respective  hospitals,  in  the  treat- 
ment of  acute  cases  under  both  systems.  For  the  same  reason 
the  results  of  the  treatment  of  many  acute  cases  recorded  by 
Professor  Henderson,  of  Edinburgh,  former  Physician  and  Clini- 
cal Professor  to  the  Eoyal  Infirmary,  were  of  the  greatest  interest. 
In  aU  these  instances  and  in  others,  which  he  could  quote  were 
it  necessary,  it  was  not  sought  to  pit  the  results  of  the  treatment 
of  one  physician  against  those  of  the  treatment  of  another,  nor  of 
one  Hospital  against  those  of  another,  but  of  the  new  mode  of 
treatment  against  that  of  the  old  in  the  hands  of  the  same  phy- 
sicians. Here  there  can  be  entertained  no  suspicion  of  a  wish  to 
triumph  over  an  opponent  or  a  rival  Institution,  nor  a  temptation  to 
falsify  the  results.  He  (Dr.  Quin)  fully  agreed  with  the  foregoing 
speakers  in  regarding  the  Expectant  School  as  the  stepping-stone 
to  Homoeopathy ;  and  when  one  compared  the  mode  of  treatment 
practised  by  allopaths  some  years  ago,  with  that  pursued  by  them 
at  the  present  day,  there  could  be  little  doubt  that  it  tended 
more  and  more  towards  Expectancy,  which  he  looked  upon  as  the 
high  road  to  Homoeopathy.  At  one  of  the  Society's  meetings  many 
years  ago,  when  the  debate  took  a  similar  course  to  that  which 
it  had  done  to-night,  he  had  referred  to  an  anecdote  told  of  an  old 
£riend  of  his,  a  distinguished  physician  and  Military  Surgeon-in- 
chief  of  the  Austrian  Army  in  Bohemia,  Dr.  MahrenzeUer^  "wIlo^ 


I  2C)  Dr.  Oxaiinr  on  the  Positive  Sa^vices 

^vll('Tl  lie  first  made  his  acquaintance,  practised  at  Prague.  As 
the  anecdote  bore  upon  the  point  touched  upon  by  several  of  the 
speakers  this  evening,  he  trusted  they  would  not  think  it  irrele- 
vant his  again  relating  it : — **  Dr.  Mahrenzeller  having  passed  most 
of  his  nunlieal  career  in  the  Anny,  and  in  great  Military  Hospi- 
tals, was,  what  was  held  in  the  highest  esteem  some  years  ago  in 
England,  and  denominated,  an  active  practitioner,  one  dealing  in 
heroic  remedies,  in  large  doses,  copious  bleedings — in  short,  in 
violent  medicines,  both  internal  and  external.  When  the  head- 
quai'ters  of  the  Division  of  the  Army  to  which  he  was  attached 
was  stationed  at  Prague,  he  Avas,  from  the  high  position  which  he 
held,  much  consulted  ]>y  the  townspeople  of  the  wealthier  class, 
and  his  ])ractice  extended  itself  greatly  among  the  civil  as  well 
as  the  military  ;  so  much  so,  that  few  cases  of  danger  occurred  in 
which  his  advice  was  not  sought.  It  w^ould  seem  that  the  mili- 
tary medical  practice,  which  he  introduced  into  civil  life,  had 
an}i:hing  but  a  favourable  issue  in  the  majority  of  his  cases ;  so 
much  so,  that  the  churchyard  became  rather  densely  peopled, 
and  w\as  known  under  the  name  of  Mahrenzeller's  Garden.  His 
reputation  naturally  suffered,  and  his  practice  gradually  dwindled 
aAvay.  Shocked  and  horrified  at  these  melancholy  results  of  his 
heroic  mode  of  treatment,  he  became  disgusted  with  it  and 
himself,  and  resolved  to  see  w^hat  would  be  the  result  of  leaving 
Nature  to  herself.  This  he  commenced  doing  in  his  hospital,  and 
his  practice  was  so  much  less  fatal,  that  he  gradually  introduced 
it  into  his  private  practice,  and  he  confined  his  prescriptions  to 
bread  pills,  an  occasional  mild  aperient  and  diluents.  About  this 
time  the  General-in-Chief  of  the  Army,  Prince  Schwartzenburg, 
w^ho  had  long  been  suffering  from  a  painful  disorder,  from  which 
he  could  obtain  little  or  no  relief  from  the  usual  means,  resolved 
upon  consulting  Hahnemann,  at  that  time  rising  into  fame,  as 
the  founder  of  a  new  system  of  medicine.  He  left  Prague  accom- 
l)anied  by  Dr.  Mahrenzeller  for  that  purpose.  The  beneficial 
results  attendant  upon  Hahnemann's  advice  were  such  as  to 
induce  Mahrenzeller  to  consult  him  upon  a  disease  from  which 
he  had  himself  been  suffering  for  some  time.  The  benefit 
was  so  marked,  that,  already  in  some  measure  prepared  by 
his  disappointment  at  his  old  mode  of  practice,  and  at  the  less 
unfavourable  results  of  the  Expectant,  he  resolved  to  study 
Homneopathy,  and  finally  became  one  of  the  most  distinguished 
homoeopathic  physicians  in  Germany,  first  at  Prague,  and  then  at 
Vienna,  w^here  his  success  greatly  tended  to  the  spread  of  the  new 
system.  It  was  to  him  that  was  entrusted  the  homoeopathic  ex- 
periments ordered  by  the  Emperor,  to  be  made  in  the  great 
Allopathic  Military  Hospital  at  Vienna — the  Joseph's  Academy 
Hospital — ^which  experiments  were  so  successfiil,that  they  resulted 
in  the  conversion  of  one  of  the  Commissioners  appointed  by  the 


of  thi' SfhiHtl  t'f  Iluhmnnrini,  y2.1 

Government  to  watch  and  rop<»rt  iip(»n  tln'in,— Pn»i'i'ssnr /Inra- 
to-witz.  Dr.  Mahrenzoller  liad  in  liis  own  Military  Hns]iital.  at 
l*rague,  full  oppoilnnity  of  watiliiii^'  and  tlicidin^'  n|H»n  tin* 
respective  merits  and  advantayt's  of  tin*  tlnv<'  nn'tlmds  nt*  In-at- 
ment  inaxiute  diseases, ])ractised  by  liinisi'lf,  at  tlin'ctiiirm'nl  pe- 
riods— ^the  AUopatliic,  the  Expectant,  an«l  the.  iromn-oimthic — and 
the  statistics  obtained  by  each  mode  caused  liini  t«»  <leride  upon 
the  latter  as  infinitely  the  .su])('nor."  With  rfsjH'ct  to  the  obsrr- 
vations  of  Dr.  liussell,  concerninf^  the  threat  revdbition  which  has 
taken  place  of  late  years  in  tlie  use  of  the  lanci't  in  inllaniuiatiny 
diseases,  and  more  especially  in  a])o]»lexy,  and  to  tlie  interrstin^ 
quotation  from  Dr.  iiadclifle's  work  (ju  ('nu<:« -st ion  of  the  Uraiii 
and  Apoplexy,  in  which  the  important  aihnission  was  made  on  tlie 
inutility,  nay  harm  of  bloedin*:;  in  a])0])lexy,  he  (Dr.  Quiuj  recol- 
lected the  time  when  the  medical  man  who  abstract«Ml  the; 
greatest  quantity  of  blood  was  looked  up  to  as  a  hero  and  a  most 
skilfid  practitioner,  whose  footsto])S  ought  to  b(»  ibllowe<l  and 
imitated ;  and  even  after  mc^n  began  to  (lou])t  the*  ])ropriety  of 
the  practice,  and  see  the  danger  of  using  such  large  depletions, 
such  was  the  force  of  example  and  custom,  and  such  the*  tyranny 
of  authority,  that  practitioners  resoited  often  to  bleeding,  in  spite 
of  their  better  judgment,  to  shelter  themselves  from  the  blame 
and  obloquy  that  they  were  sure  to  incur,  if,  on  being  first  call(»d 
to  a  patient,  they  neglected  co]>ious  venesection.  It  Avas  on  th(^ 
Continent  that  this  salutar}'  revoluticm  first  commenced,  lie  (Dr. 
Quin)  remembered,  as  far  back  as  1829,  a  circumstance  which  he 
had  mentioned  in  a  former  debate  (in  1846)  just  after  the  deide- 
tory  system  introduced  by  Broussais  began  to  lose  caste  and 
show  its  baneful  effects,  so  as  even  to  stagger  the  author  of  the 
physiological  system  of  treatment,  Broussais  himself,  that  Fou- 
quier,  the  Physician  to  the  Salpetri^re  Hospital  in  Pans,  with 
whom  he  (Dr.  Quin)  had  several  consultations  at  that  time, 
Fouquier  being  a  great  authority  in  diseases  of  congestion  anti 
inflammation, — in  fact,  in  all  diseases  connected  with  the 
vascular  system, — acknowledged  that  he  believed  blood-letting 
in  apoplexy  to  be  not  only  of  no  avail,  but  positively  inju- 
rious. He  had  put  it  to  the  test  in  the'  wards  of  his 
hospital  in  the  following  manner : — The  Salpetriere  had  more 
cases  of  apoplexy  and  epilepsy  than  the  other  hospitals  of  Paris, 
and  a  number  of  the  cases  occurred  in  old  veterans.  All  the 
cases  that  came  into  the  hospital  on  Mondays,  AVednesdays,  and 
Fridays,  were  put  into  one  ward,  and  aU  those  that  came  in  on 
the  alternate  days  were  put  into  another  ward ;  and  Fouquier 
ordered  the  patients  of  one  ward  to  be  treated  according  to  the 
usual  mode  hitherto  pursued  in  the  Hospital,  viz.  by  venesec- 
tion, cupping,  leeching,  and  other  antiphlogistic  means,  whilst 
the  inmates  of  the  other  ward  were  none  of  them  bled  or  reduced 


1 28       Dr.  Rartfiford  on  sortie  Affections  of  the  Knee-Joint, 

by  other  depletory  means,  but  rather  sustained  and  slightly  nou- 
rish(^d  :  tlu*  result  was,  that  he  lost  considerably  fewer  patients 
in  the  latter  ward  than  in  the  former.  The  experiments  ex- 
tended over  several  weeks,  and  ended  in  Fouquier  abandoning 
the  practice  of  blood-letting  in  such  cases.  Here,  again,  we  have 
the  statistics  in  the  same  hospital,  under  the  direction  of  the 
same  ])hysician,  treating  similar  cases  by  two  different  modes, 
proving  in  favour  of  the  one  mode  over  the  other,  in  a  manner 
wliich  cannot  be  considered  open  to  suspicion.  He  (Dr.  Quin) 
heartily  concurred  in  the  eulogy  passed  by  Dr.  Chapman,  who 
was  always  generously  alive  to  the  merits  of  his  colleagues,  and 
ready  to  record  in  his  speeches  his  favourable  opinion  of  their 
labours.  The  past  and  present  labours  of  the  author  were  most 
important  and  praiseworthy ;  and  he  earnestly  hoped  that  Dr. 
Ozaune  woidd  continue  to  give  to  the  Society  the  results  of  his 
research  and  experience.  The  evidence  brought  by  Dr.  Chep- 
mell  in  practical  illustration  of  the  paper  of  his  relative,  Dr. 
Ozanne,  was  well  worthy  of  their  attention,  particularly  the  for- 
midable and  complicated  case  of  his  little  daughter,  of  which  he 
had  given  the  most  minute,  circumstantial,  and  interesting 
details.  The  history  was  a  harrowing  one,  and  they  must  aU 
feel  the  deepest  sympathy  for  the  father  who  witnessed  in  a 
beloved  cliild  such  a  succession  of  violent  diseases  occurring 
with  such  rapidity,  and  he  (Dr.  Quin)  heartily  congratulated 
him  on  the  fortunate  escape  of  the  child  from  such  repeated 
imminent  periods  of  danger  and  its  final  rescue  from  the  jaws  of 
death.  Such  a  case  as  that,  so  feelingly  told  by  a  parent,  ought  to 
carry  conviction  into  the  most  obstinate  opponent  of  our  school, 
of  the  good  faith  and  earnest  and  conscientious  belief  of  the 
narrator  in  the  blessings  conferred  on  us  by  the  great  discoveries 
of  Hahnemann. 


ON^  SOME  AFFECTIONS  OF  THE  KNEE-JOINT. 
By  Dr.  Eansford. 
Upwards  of  thirty  years  since,  when  dresser  at  the  Bristol 
Eoyal  Infirmaiy,  I  had  under  my  charge  a  little  girl  of  stinimous 
habit,  about  seven  years  of  age,  who  suffered  from  what  was 
called  a  white  swelling  of  the  knee-joint.  It  was  a  case  of 
chronic  inflammation,  originating,  probably,  in  the  synovial 
membrane,  but  in  which  the  other  textures   had  become  in- 


Trivei     TLe:^  "ins  c:'::::r.'r:-:\l  ]«axn.  wiili  u'n'at  onlarufinout  ol 

tie  i::iil  "Br]:::!:  jres-jiitoi  :ho  piviiHar  whito  anjuMiaihT  rioiu 
vliiL  tie  iL^ne  -wLito  swtllini;"  is  ul'i.iiiuil.  Tlu'  nmihiii 
of  llr  y-iiLZ  •«"«  VvT}*  l::r.:Ti\l :  ^xti  n^inn  «'f  tin*  liinl*  rouiil  imt 
l»r  ror^r:  ::.5  iisu.i!  }'.'<:::"ii  >va>  ilif  Iialf-luut  tiiif;  !h.«  ]i.ilirri! 
W-^iTT.-r  Lr:::.\  ?!-:-t]'>'.5>  :  lur  luallli  was  ra|»iil!v  f.iiliii;'  Sin- 
Lad  \K-rii  :vr.-.i^:-J  with  looohrs.  tartar  niuii*'.  niiiinii  iit,  Mi.i- 
lirTs.  krj't  oj«en  l-y  Sabiiio  ci-rato  ainl  all  tin-  i»llnr  Ih-IiIn  |.ii.i.| 

appliiincr*  cf  the  Jay.  iiiohulinir  issui^s  anil  mMimis.  r.irij i.l 

vitli  drugs  of  all  sons,  aiul  giwn  in  all  shaju-v     Tlw  Sm  ■. 

who  weK  men  of  emiiuneo,  iIooIiUmI.  afiiT  fiinsuliali«m.  tli.ii  tin* 
limb  must  t«e  amputatoil.  or  that   tin'  rliild  \vi»ulil  .•.)».■.  .IiIn  <!h- 
This  decision  was  coimnunioatod  \o  tlu*  iimtlii  r.  w  Im  wmiM  imi  • 
consent  to  the  operation,  and  ivnii»\ril  Inr  cliilil  \'vu\\\  tin*  luiii 
man"  to  her  own  eottagi\alu»iit  thnv  niili's  iVum  I'li-.d)!.     ;hiiiu« 
months  aftenvards  I  was  in  tlu»  ni'i«;Ii!MMirliiMMl  o\'  Iht  iiiuiIm  i.j 
house,  and  called  to  inquiiv  whi'tluT  tlir  cliilil  wmm  lixin;-       Tn 
my  astonishment  I  found  Iior  walkin<^  alxuit.  in  lair  Ih-allli.  uinl 
the  afiected  limb  not   very  tlilViM-ent  iVnm  its  jrllnw.       I   w.n 
informed  that  a  surgoon,  practisinj^  in  tin*  iicij-jilMHuinMMJ,  JKid 
done  it  up  verj"  caivfully  with  a  variety  of  plai.lrr.i  iimi  mni 
ments:   and  by  these   moans   Ihti  j^'irl    hail    ln-ni  rmiil       'lint 
surgeon  (so  called,  for  ho  was  an   imh'ri'ii mmI   piaciiiioiK-i  i  hiul 
become  familiar  with  the  tivatnu'iil   ;uli»plri|    liv  Mm-  lulr    Mr 
Scott,  of  Bromley,  Kent,  and   apply iii;.j   il.   In   Hhm   rliilij    wa.i 
rewarded  with  signal  success.     Tlu*  cnse  \v:i;*  (uk^  ('.Ml«'iilal.«Ml   in 
make  a  lasting  impix^ssion  upon  the  iiiiiid  of  :i  .".liidcnl.  ui-niik 
tomed    to    consider  the    oracular  sayin^^s    and    dnin;':j   nl    lii.i 
teachers  as  decisions  from  which  thrro  wjis  no  jippcal.      I  did 
good  to  many  cases  in  my  pupila^'o   u]K)n   this  prinriph-,  :ind 
studied  with  interest  Scott's   work,  entitled  "On  |ji(>  Tr<:ilhniif. 
of  Diseases  of  the  Joints  and  of  Tlrei-s  and  Ciirnnic  Inilaninm 
tion."     This  work  was  not  favourably  niccivr-d    hy  tlic  prof.-.i- 
sion.      It  was  severely  criticised,  and   f«)r   reasons  which  may 
readily   be    assigned,    his    reviewers    pronounced    Mr.    Se.oi|.'M 


130      Dr.  Ransford  on  Rome  Affections  of  the  Knee- Joint, 

pathological  principles  to  contain  nothing  new,  and  his  plan  of 
treatment,  which  was  fully  detailed,  was  slighted  and  dis- 
couraged Indeed,  the  history  of  this  work  well  illustrates 
professional  prejudice.  It  has  been  correctly  observed,  "  that 
altliough  an  accurate  description  of  diseased  states,  and  the  dis- 
covery of  some  phenomena  about  them  not  previously  recog- 
nised, are  hailed  by  the  profession,  and  confer  immediate  dis- 
tinction upon  the  author  or  observer ;  yet  remedies,  or  plans  of 
treatment,  however  effective  and  valuable,  are  always  received 
very  coldly,  frequently  with  perfect  indifference,  and  sometimes, 
nay  often  (as  the  members  of  this  Society  can  testify),  meet 
with  unsparing  and  unscrupulous  opposition."  We  could 
produce  abundant  unimpeachable  testimony,  that  John  Scott 
succeeded  in  curing  numbers  of  surgical  cases  which  had  been 
pronounced  hopeless  by  many  eminent  surgeons  of  the  day. 
In  fact,  he  saved  for  his  patients  innumerable  limbs  which  had 
been  condemned  to  amputation.  In  the  few  cases  which  I 
shall  have  the  honour  to  read  this  evening,  it  wiU  be  seen  that 
I  have  ceased  to  follow  Mr.  Scott's  mode  of  practice,  because 
we,  the  professed  disciples  of  Hahnemann,  believe  ourselves  to 
be  in  possession  of  a  stiU  surer  guide  to  the  administration  and 
application  of  remedial  agents,  so  far  as  the  Materia  Medica  is 
concerned;  at  the  same  time,  although  we  were  never  acquainted 
with  each  other,  I  should  not  have  considered  myself  just  to 
John  Scott's  memory  had  I  not  given  my  feeble  testimony  to 
his  skill.  Undeterred  by  opposition  or  the  severity  of  his 
critics,  he  continued  his  practice,  and  realized  by  it  a  large 
fortune.  He  laid  considerable  stress  on  giving  the  affected 
joint  rest,  and  applying  uniform  and  gentle  pressure  to  it.  In 
addition,  he  bathed  the  parts  with  Camphorated  Spirits,  and 
applied  Mercurial  Ointment  with  Camphor.  In  all  injuries 
and  diseases  of  the  joints  in  the  slow  strumous  degeneration 
luhite  siveUing  (a  very  vague  and  comprehensive  term),  as  well 
as  in  the  most  violent  form  of  articular  inJBammation,  perfect 
repose  of  the  affected  joint  forms  a  powerful  and  effectual 


Dr,  Hansford  on  some  Affections  of  the  Knee-Joint,      1 81 

curative  indication.  The  means  described  by  Mr.  Scott  per- 
fectiy  secured  the  quiescence  of  the  joint;  but  it  does  more 
than  this, — it  excites  and  maintains  a  gentle  warmth  and 
action  upon  the  skin  over  a  large  surface  around  and  con- 
tiguous to  the  diseased  joint,  and  thus,  by  the  well-known 
principle  of  counter-irritation,  relieves  and  subdues  the 
inflammatory  action  in  the  structures  of  the  joint  itself; 
besides  which.  Mercury  is,  to  a  cei*tain  extent,  homoeo- 
pathic to  many  of  these  cases.  Sii*  Benjamin  Brodie's  work 
gives  information  respecting  the  pathology  of  diseased  joints ; 
but  we  believe  that  Mr.  Scott's  work  gives  better  instructions 
for  curing  them,  so  far  as  Allopathy  is  concerned.  It  will  not 
be  disputed  that  afifections  of  the  joints  are  a  class  of  diseases 
which  have  strong  claims  on  the  attention  of  practitioners, 
since  they  are  of  frequent  occurrence,  are  sources  of  deep 
anxiety  to  the  patients,  and  for  the  most  part,  if  neglected  and 
maltreated,  proceed  to  an  unfavourable  teimination.  I  venture 
to  bring  forward  two  or  three  cases,  with  the  hope  that  the 
suflBciency  and  superiority  of  treatment  suggested  by  the 
homoeopathic  law  may  be  apparent.  The  first  case  may 
perhaps  be  termed  one  of  chronic  inflammation  of  the  synovial 
membrane,  arising  from  constitutional  causes,  which,  as  my 
audience  well  knows,  are  often  vague  and  diverse,  and  into 
which  part  of  the  subject  too  much  time  would  be  required  for 
me  to  venture  upon ;  besides  which,  such  a  disquisition  would 
perhaps  land  us  in  the  regions  of  hypothesis.     The  subject  of 

this  case,  Henry  M ,  had  been  an  intemperate  man ;   there 

was  likewise  reason  to  suspect  a  sjrphUitic  taint.  Eheumatic 
or  gouty  symptoms  presented  themselves,  arising  probably  from 
hereditary  predisposition,  fostered  by  the  patient's  habits  of 
life  and  exposure  to  atmospheric  changes.  He  first  consulted 
me  in  York  on  August  28,  1855.  His  age  was  31,  unmarried ; 
his  occnpation  groom  and  valet ;  he  resided  in  tlie  country, 
within  six  miles  of  York.  He  has  an  enlargement  of  the 
left  knee-joint,  with  great  pain,  which  is  worse  when  he  walks ; 

9* 


1  ;V2       Dr.  Ransford  on  some  Affections  of  the  Knee-Joint 

and  lie  described  the  pain  as  running  down  to  the  ankle  and  up 
to  tlie  slioiilder.     Appetite  had. 

IIc'[)ar  Sulphuris  6  was  ordered. 

Sept.  3. — The  joint  is  smaller;  the  pain  is  less;  he  feels 
hettt^r.  Hopar  was  continued;  and  a  cloth,  dipped  in  a  solution 
of  Hepar,  was  ordered  to  be  applied  as  a  compress  to  the  joint. 

Sept.  22. — Much  better.  The  pain  is  trifling.  The  joint 
becomes  stiff  after  moving  much  about.  Sulphur  was  ordered 
internally,  and  externally  as  a  lotion.  Unfortunately,  about 
tliis  time  he  was  kicked  by  a  horse  on  the  shin  of  the  aflfected 
limb ;  the  consequence  was  a  contused  wound,  to  which  Arnica 
cerate  was  applied  with  success ;  but  after  the  wound  healed 
ulcers  appeared  on  the  leg,  which  ulcers  were  obstinate.  Calendula 
cerate  and  strapping  did  some  good,  but  the  internal  exhibition 
and  external  application  of  a  solution  of  SiUcea  produced  more 
speedy  amendment.  The  knee-joint  was  comparatively  well, 
but  the  ulcers  on  the  leg  were  tedious.  During  the  time  that 
he  was  under  treatment  he  took  Silicea,  Hepar  Sulphuris,  Sul- 
phur, Graphites,  Belladonna,  Arsenicum,  and  Nux  Vomica, 
according  to  indications.  He  was  under  my  care  from  August 
28tli,  1855,  to  March  2nd,  1856;  after  this  I  neither  saw 
nor  heard  of  him,  because  he  was  able  to  fulfil  his  duties  as  a 
servant,  until  February  16  th,  1857,  when  he  called  again  upon 
me  on  account  of  the  appearance  of  fresh  ulcers  in  the  same 
leg :  these  healed  in  a  month  under  the  use  of  Silicea,  applied 
externally,  and  taken  internally.  Fortunately  for  my  patient, 
he  did  not  adopt  the  recommendation  of  an  hospital  surgeon  of 
eminence,  who,  previous  to  his  first  application  to  me,  had  tried 
upon  him  the  usual  orthodox  remedies,  and  concluded  by 
recommending  amputation  of  the  aflfected  limb. 

The  details  of  the  next  case  were  sent  to  me  by  a  clergy- 
man in  the  north  of  Ireland,  with  a  request  for  my  opinion 
and  advice.  I  prescribed  the  external  application  of  Arnica : 
the  result  was  most  gratifying.  T  read,  without  alteration,  the 
account  as  sent  to  me  in  October,  1860  : — 


Dr.  Ransford  on  some  Affectiom  of  the  Knee- Joint,       133 

"Elizabeth  M'Kenn,  aged  19,  suffered  for  several  months 
from  a  swelling  in  the  knee.  The  pain  was  excruciating,  and 
the  leg  was  greatly  inflamed,  and  swollen  to  double  the  natural 
size.  Several  doctors  were  consulted — I  believe  six  altogether. 
One  recommended  'warm  poultices,  to  cause  suppuration;* 
another,  scarifyiug  and  blistering;  another  said  that  'imme- 
diate amputation  was  the  only  way  to  save  her  life;*  another 
said  the  disease  was  'Elephantiasis.'  She  suffered  intense 
pain,  could  make  no  use  of  the  swollen  limb,  and  got  no  sleep 
for  a  long  time.  I  visited  her  under  these  circumstances  as  a 
clergyman,  and  by  the  advice  of  a  physician  practising  lioma^o- 
pathically,  recommended  a  trial  of  Arnica.  I  accordingly  gave 
some  Arnica,  with  directions  to  bathe  the  knee  witli  warm 
water,  and  then  apply  the  lotion,  rubbing  it  for  some  time 
gently  with  the  hand,  and  then  apply  well-saturated  linen  cloths, 
covering  all  with  oiled  silk;  the  applications  to  be  renewed 
every  half-hour.  In  about  two  hours  a  very  copious  eruption 
of  watery  pustules  appeared,  and  the  pain  was  greatly  abated- 
The  applications  were  continued  more  than  a  week,  but  there 
was  no  eruption  after  the  first  two  days.  The  swelling  gradu- 
ally fell,  and  the  pain  altogether  left  the  knee-joint,  wliich 
seemed  to  have  been  the  original  seat,  and  settled  about  half 
way  down  the  leg,  where  the  patient  felt  what  she  described 
as  '  a  drop  of  water  running  up  and  down  the  inner  side  of  the 
shin  bone.'  The  spot  where  the  pain  settled  was  touched  with 
a  lancet,  and  suppurated,  and  has  remained  an  open  sore  about 
as  large  as  a  fourpenny  piece,  with  a  very  slight  occasional 
discharge  at  intervals  ever  since.  In  other  respects  the  girl  is 
quite  well.  The  duration  of  treatment  with  Arnica  was  six 
weeks ;  it  is  now  about  eight  months  since  the  lotion  was  first 
applied.  The  lotion  used  was  from  6  to  8  drops  of  the 
Mother  Tincture  of  Arnica  in  a  wine-glassful  of  water,  a  fresh 
mixture  being  made  every  time  the  linen  was  saturated.  She 
was  very  weak  for  some  time,  I  believe,  from  the  intense 
sufifering.  A  doctor  says  it  arose  from  the  dangerous  Tiature  of 
tiU  lotion  used.     The  girl  continues  well." 


134      Dr.  Hansford  on  some  Affections  of  the  Knee-JoirU. 

A  few  weeks  since  my  correspondent  wrote  to  me,  "That 
last  Sunday  she  walked  to  church,  a  distance  of  eight  miles, 
there  and  home  again." 

A  somewhat  similar,  although  not  so  severe  a  case,  was  that 
of  Joseph  Neill,  eight  years  of  age,  who  applied  at  the  York 
Homeopathic  Dispensary  on  12th  August,  1851.  He  was 
apparently  in  good  health,  but  of  a  strumous  diathesis.  The 
left  knee  is  swollen,  white  and  tense,  painful  when  touched  or 
moved.  Aconite  and  Arnica  were  prescribed  internally.  No 
external  application  of  any  kind  was  ordered.  The  swelling 
gradually  lessened ;  Sulphur  was  then  given  for  two  days.  On 
the  30th  of  August,  eighteen  days  after  his  first  appearance 
at  the  dispensary,  the  swelling  was  almost  gone;  he  walked 
much  better. 

Sept.  6th. — Improvement  continues;  joint  remains  stiff; 
Arnica  embrocation  was  ordered.  On  the  27th  of  September 
he  was  discharged  cured. 

The  next  case  was  that  of  John  Smallwood,  aet.  4 ;  likewise  a 
dispensary  patient  in  York.  He  looked  delicate,  of  a  strumous 
constitution.  The  right  knee  was  enlarged,  and  had  been  so 
for  three  months  without  any  obvious  cause.  Sulphur  30  was 
given  for  a  week,  then  Calcaric  Carb.  30  for  17  days;  the  swelling 
and  pain  had  both  diminished;  a  compress  of  cold  water  covered 
with  oiled  silk  was  ordered. 

February'  10th. — The  knee  is  smaller,  general  health  good; 
Iodine  30  was  given,  and  the  cold  water  compress  continued. 
On  the  4th  of  March  there  was  no  pain  in  the  joint, — he  walks 
better.  A  week  afterwards  the  diseased  joint  is  found  to  be  only 
half  an  inch' larger  in  circumference  than  the  other.  Calcarea 
30  was  resumed,  and  continued  imtil  April  7th,  when  he  was 
discharged  cured. 

Another  and  a  very  simple  case  was  that  of  Annie  Low,  set.  14, 
residing'  at  Penge.  She  applied  at  the  Sydenham  Dispensary 
on  the  25th  of  March,  1862  ;  the  left  knee  was  very  painfid, 
swollen,  and  evidently  contained  fluid.  She  walked  with  dif- 
ficulty :  cloths  dipped  in  a  lotion  of  Arnica^  and  covered  with 


Dr,  Ranrford  on  sonie  Affections  of  the  Knee-^oiiU,       1 35 

oiled  Bilk,  were  ordered ;  in  less  than  two  weeks  there  was  dimi- 
nution of  pain  and  swelling.  On  the  8th  of  April  she  reported 
herself  cured,  and  ceased  to  attend 

The  next  case  with  which  I  shall  trouble  you  was  that  of  Ellen 
Bogers,  set  18,  admitted  at  the  Sydenham  Dispensary,  on  the 
1 8th  of  April  last.  She  is  a  fine  healthy  girl,  and  states  that  she 
fell  down  in  December,  1862,  and  struck  her  right  knee,  but 
did  not  feel  any  pain  in  the  knee  imtil  March,  1863  ;  she  then 
went  to  St.  Mary's  Hospital,  on  the  2nd  of  April  following,  as 
an  out-patient;  she  continued  going  until  April  22.  During  that 
time  the  tumour  of  the  knee  was  lanced  twice  in  one  week,  and 
pus  mixed  with  blood  was  evacuated  on  each  occasion ;  two 
blisters  in  succession  were  applied  to  the  swelling  after  that ; 
subsequently  the  knee  was  painted  with  Iodine.  When  she  came 
to  me,  the  swelling  over  the  patella  of  the  right  knee  was  con- 
siderable and  tense,  the  surface  raw;  she  walked  with  great 
difficulty,  but  her  general  health  was  good.  I  ordered  Silicea 
Tinct.  6  to  be  mixed  with  lard  and  kept  applied  to  the  pait 
aflfected.  In  four  days  she  walked  about  freely,  and  in  ten 
days  returned  to  her  home  in  Buckinghamshire.  This  case 
illustrates,  in  my  humble  opinion,  the  evil  results  of  the 
nimia  dUigentia  Chirurgici.  A  less  heroic  treatment  at  first, 
with  rest,  would  perhaps  have  been  attended  with  better  results, 
but  it  affords  fresh  proof  to  me  of  the  value  of  Silicea  given 
internally  and  applied  externally. 

And  here  I  may,  perhaps,  adduce  another  instance  of  the  value 
of  homoeopathic  treatment,  although  not  one  of  diseased  joint, 
strictly  speaking — ^but  a  case  which  Mr.  Scott  would  probably  have 
designated  Chronic  Inflammation.  A  gentleman,  aged  69,  resi- 
ding near  Barnard  Castle,  County  Durham,  wrote  to  me  for  ad- 
vice on  the  13th  August,  1862.  I  have  never  seen  him,  but 
give  you  the  details  of  his  case  as  I  received  them,  though  di- 
vested of  much  irrelevant  matter.  In  February,  1 8  6  2,  he  writes : 
**  I  scratched  my  left  ankle,  and  produced  a  wound  in  it  larger 
than  a  shilling ;  my  leg  was  then  in  places  very  black.    I  applied 


136      Dr,  Ransford  on  some  Affections  of  the  Knee- Joint 

to  the  doctor  here,  to  heal  it,  but  he  could  not,  and  it  discharged  a 
little  thick  white  matter — then  my  foot  swelled  and  puffed  up.  I 
was  advised  to  drink  broom  tea,  which  I  did,  and  do  still  drink 
it,  and  wear  a  bandage  from  my  foot  to  my  knee ;  but  this  was 
all  to  no  purpose,  my  foot  was  considered  dropsical,  and  the  doc- 
tor ordered  me  broom  tea  for  it,  and  frequently  applied  Caustic 
to  the  wound,  which  gave  me  much  pain.  Since  then  my  leg 
became  full  of  red  spots,  like  pin  points,  up  to  my  knee ;  and 
these  red  spots,  after  some  days,  became  of  a  scarlet  red  all  over 
my  leg  and  foot,  with  much  hard  swelling  all  over  my  leg  up 
to  my  knee.  My  knee  and  ankle  joints  are  very  stiff  and  scaly ; 
there  is  also  a  tremendous  itching,  which  continues  at  times, 
especially  in  the  night ;  the  itching  is  likewise  about  my  arms, 
eyebrows,  chin,  neck,  head,  ears,  body,  and  all  around  my  private 
parts,  having  a  yellowish  appearance.  The  wound  in  my  leg  is 
not  healed  up ;  it  is  small — was  never  very  deep."  According 
to  his  own  statement,  he  had  lived  freely,  and  took  a  great  deal 
of  salt  with  his  food ;  since  February  he  has  been  a  total  ab- 
stainer. Appetite  is  good.  He  is  now  taking  Dr.  Eooker*s  Pills 
(which  I  never  before  heard  of) :  he  formerly  applied  Tar  Oint- 
ment, but  now  rubs  his  leg  with  Holloway's  Ointment ;  he  adds 
a  postscript,  that  he  had  for  thirty  years  been  much  troubled  with 
rheumatism,  and  during  the  last  ten  years  he  had  been  compelled 
to  walk  with  two  sticks.  For  this  not  very  promising  state  of 
matters,  I  ordered  Belladonna  and  Arsenicum,  to  be  taken  alter- 
nately, and  Tinct.  Belladonna  with  water  to  be  applied  on  a 
cloth,  oiled  silk  to  be  worn  outside  the  cloth ;  the  broom  tea, 
Eooker's  Pills,  Holloway's  Ointment,  were  to  be  inmiediately 
discontinued.  In  the  course  of  a  week  he  reported  himself  im- 
proved, the  itching  and  swelling  of  the  limbs  had  diminished, 
the  limbs  and  joints  were  stiff  from  what  he  described  as  a  hard 
scaly  scurf  upon  them;  the  urine  had  increased  in  quantity,  not- 
withstanding the  discontinuance  of  the  broom  tea ;  the  scaly 
condition  abated,  and  gave  place  to  healthy  skin ;  the  urine  was 
described  as  having  a  deep  red  sediment  in  it.     Ten  days  after- 


1 38      Dr.  Ransford  on  some  Affections  of  the  Knee- Joint, 

pose  that  medicioe  and  diet  are  all  that  are  necessary  for  the 
treatment  of  local  disorders,  and  that  local  remedies  are  needless. 
We  believe  that  it  is  by  scrupulous  attention  to,  and  a  proper 
application  of  the  latter,  that  will  make  our  practice  the  most 
successful" 

Since  writing  the  foregoing,  my  friend  Dr.  Duncan  Campbell, 
of  South  Shields,  sent  me  two  very  interesting  cases :  from  per- 
sonal acquaintance  I  can  vouch  for  Dr.  Campbell's  accuracy 
in  diagnosis  and  description,  and  have,  therefore,  much  pleasure 
in  bringing  them  before  you  at  this  time.  The  first  case 
is  that  of  Mary  Wood,  aged  18  years : — "  She  has  endured 
with  great  patience  the  many  torturing  means  used  by  allopa- 
thic science.  Wood  consulted  me,  for  the  first  time,  on  the  10th 
October,  1862.  Before  I  could  possibly  question  her,  she  gave 
me  a  very  fuU  and  descriptive  account  of  her  sufferings ;  she 
was  leeched,  blistered,  cauterised,  and  otherwise  very  much 
pained,  in  the  vain  hope  of  obtaining  a  cure.  On  questioning 
her,  she  said  she  never  aUed  anything  in  her  lifetime  before  the 
occurrence  of  the  present  mishap,  which  took  place  in  the  fol- 
lowing manner: — Coming  down  stairs  very  rapidly,  and  turn- 
ing round  on  the  landing,  her  left  hand  got  between  two  of  the  up- 
rights protecting  the  stair  sides.  Although  painful  at  the  mo- 
ment, she  took  no  particular  notice  of  the  accident  till  three 
days  afterwards ;  the  wrist  .joints  got  very  painful  and  swollen, 
the  part  gradually  got  worse ;  the  pain  she  described  as  unbear- 
able and  deep-seated,  greatly  aggravated  by  pressure  or  motion ; 
there  was  tenderness  of  the  integuments,  and  a  good  deal  of 
constitutional  disturbance.  The  family  surgeon  was  then  called 
in:  he  ordered  leeches  and  perfect  rest,  which  orders  were  strictly 
obeyed  (a  few  doses  of  castor  oil  were  also  taken).  Thus  mat- 
ters went  on  for  nearly  a  month,  but  as  the  inflammation  sub- 
sided, a  stiffening  of  the  joint  ensued.  The  stiffening  went  on  in- 
creasing, tOl  at  last  the  joint  was  incapable  of  any  kind  of  mo- 
tion ;  she  then  submitted  to  a  course  of  blistering,  taking  at  the 
same  time  some  of  the  so-called  alterative  medicines  (such  aa 


Dr.  Ransford  on  some  Affections  of  the  Kiiee-Juint.       139 

Iodine,  Potass,  &c.).  These  giving  no  rolief,  the  actual  caut(»ry 
was  applied  in  three  parallel  lines  on  the  palmar  aud  dorsal 
aspects  of  the  joint  The  wounds  were  kept  open  for  nearly  six 
weeks ;  they  suppurated  freely,  but  no  good  results  followed. 
She  got  tired  of  the  mode  of  treatment,  and  an  aunt  (a  patient 
of  mine)  got  her  persuaded  to  try  wliat  I  could  do  for  her.  On  ex- 
amining the  joint  carefully,  I  found  a  pci-ceptiWe  motion  exist- 
ing between  the  bones  composing  the  wrist-joint  pi-ojxir ;  pain 
stiU  existed  on  moving  it,  but  the  pails  were  much  swollen  from 
subcutaneous  effusion, — I  have  no  doubt,  brought  on  by  the  use 
of  the  actual  cautery :  this  satisfied  me  that  the  articulation  was 
not  so  seriously  involved  as  supposed.  Her  constitution  was  good, 
and  I  having  diagnosed  favourably,  began  the  treatment  with 
Arnica  lotion,  of  strength  3i  ^o  S^ii  Aqua  Pura,  to  be  rubbed  in 
three  times  a  day.  I  gave  her  Arnica  3  internally,  every  four 
hours.  For  the  first  week  no  change  was  perceptible,  but  at  the 
end  of  five  weeks  she  was,  and  felt  herself,  so  much  better,  that 
she  asked  leave  to  discontinue  her  visits  at  the  surgery.  I  pre- 
vailed upon  her  to  come  once  a  week  for  a  month  longer,  which 
she  did,  and  left  finally  cured.  I  saw  her  two  months  after- 
wards :  she  was  then  perfectly  well. 

** Remarks. — ^The  treatment  was  not  changed  during  the  whole 
time  of  her  attendance.  I  forgot,  however,  to  mention,  that  at 
the  beginning  I  applied  a  long  splint,  extending  from  the  middle 
of  the  arm  to  the  extremity  of  the  fingers,  thus  ensuring  com- 
plete rest  to  the  joint  involved.  Tlie  action  of  the  continued 
application  of  Arnica  lotion  was,  in  this  case,  very  obvious,  and 
if  it  had  been  applied  at  the  first,  would  have  saved  the  patient 
great  pain  and  trouble." 

Case  2nd. 

"  John  H ,  aged  5  years,  of  a  very  scrofulous  constitution, 

came  under  my  care  on  the  1 0th  of  December,  1862.  The  elbow 
joint  of  the  right  upper  extremity  looked  seriously  involved. 
Three  wounds  discharging  a  thin  serous  fluid,  occupied  the  pos- 
terior aspect  of  the  joint ;  slight  motion  existed ;  the  joint  was 


140       Dr.  Ransford  on  some  Affections  of  the  Knee- Joint. 

much  swollen  ;  the  swelling  was  of  that  soft,  elastic,  and  colour- 
less nature,  so  commonly  seen  in  scrofulous  affections;  the 
muscles  of  the  arm  and  forearm  were  perceptibly  atrophied ;  the 
seiiiiflexeJ  seemed  the  easiest  position,  and  the  general  appear- 
ance of  the  little  patient  seemed  to  confirm  the  opinion  I  first 
formed, — an  opinion  that  this  was  a  case  of  gelatinous  degene- 
ration with  necrosis.  His  appetite  was  good,  his  bowels  were 
moved  regularly,  and  he  did  not  lose  much  flesh.  The  exciting 
cause  was  supposed  to  be  a  fall  from  his  crib  three  months 
before.  Arnica  lotion  externally,  and  Silicea  6  gtt.  1  three 
times  a  day,  constituted  my  treatment  for  two  months;  three  small 
pieces  of  necrosed  bone  came  away,  the  swelling  subsided  gradu- 
ally, but  no  return  of  motion.  I  then  substituted  Merc-Sol.  6 
for  the  Silic,  and  with  obvious  benefit.  I  now  applied  a  semi- 
flexed splint  of  pasteboard  to  restrain  him  from  abusing  the 
mobility  of  which  the  limb  was  now  capable.  He  took  Ol 
Jecor  Aselli  5ij  morning  and  night,  and  now.  May  13th,  1863, 
he  can  take  his  food  with  ease  ;  the  joint  is  somewhat  stiffer 
than  before,  the  wounds  have  all  healed  up,  and  he  is  gaining 
flesh  rapidly.  I  have  no  doubt  but  that  in  a  few  months  more 
the  joint  will  be  perfectly  restored." 

"  Diseases  of  the  joints,"  says  Mr.  Listen,  *'  originate  in  a 
variety  of  ways,  and  in  any  one  of  the  tissues  which  enter  into 
their  formation  and  composition.  These  diseases  are  attributable 
to  injury,  as  sprain  or  contusion ;  but  this  may  have  been  so 
slight,  and  so  slowly  followed  by  signs  or  symptoms  causing 
alarm,  as  somehow  to  be  nearly  forgotten,  the  mischief  being 
then  supposed  to  arise  spontaneously,  and  altogether  through 
some  vice  in  the  constitution.  Many  persons  are  so  slightly 
constituted  in  these  and  other  respects,  that  very  trifling  causes 
operate  in  deranging  the  functions  and  structure  of  their  organs 
and  apparatus." 

"  I  must  confess,"  says  Sir  Benjamin  Brodie,  "  that  in  pro- 
portion as  I  have  acquired  a  more  extended  experience  in  my 
profession,  I  have  found  more  and  more  reason  to  believe  that 


Dr.  Ransford  on  some  Affections  of  the  Knee-Joint       141 

local  diseases,  in  tie  strict  sense  of  the  tenn,  are  comparatively 
rare.  Local  causes  may  operate,  so  as  to  render  one  organ 
more  liable  to  disease  than  another ;  but  everything  tends  to 
prove,  that  in  a  majority  of  cases  there  is  a  morbid  condition* 
either  of  the  circulating  fluid  or  of  the  nervous  system,  ante- 
cedent to  the  manifestation  of  disease  lq  any  particular  struc- 
ture, but  the  constitutional  conditions  giving  rise  to,  or  associated 
with,  diseases  of  the  joints,  are  as  various  and  as  different  as 
the  local  phenomena." 

In  conclusion,  we  hope  that  in  the  details  and  results  of  the 
cases  which  have  now  been  laid  before  you,  although  in  an 
imperfect  manner,  we  have  demonstrated  the  value  of  the 
therapeutic  principles,  simple  and  harmonious,  with  the  symp- 
toms presenting  themselves.  An  inestimable  boon,  which  let 
us  never  forget,  we  owe  to  the  genius  and  perseverance  of 
Hahnemann.  We  can  afford  to  disregard  the  contemptuous 
observation  of  Sir  Benjamin  Brodie  in  the  fifth  edition  of  his 
elaborate  work  on  diseases  of  the  joints.  It  is  an  observation 
unworthy  of  his  well-earned  reputation.  In  treating  of  hysteric 
diseases,  he  enumerates  various  cases  of  sudden  recovery  upon 
the  exhibition  of  some  new  medicine,  or  the  application  of 
some  new  plaister  or  liniment,  which  has  therefore  obtained, 
though  it  has  not  deserved,  the  credit  of  the  cure.  The  worthy 
Baronet  adds,  "  that,  as  might  be  expected,  examples  of  similar 
cures  have  been  furnished  by  Mesmerism  and  Homoeopathy." 

DISCUSSION. 

Dr.  Drury  regretted  that  there  were  so  few  members  present 
to  hear  the  valuable  paper  with  which  Dr.  Ransford  had  favoured 
the  society.  like  others  of  his,  it  dealt  more  with  practice  than 
theory,  and  useful  hints  thus  thrown  out  often  proved  very 
serviceable  when  similar  cases  arose.  Such  hints,  however,  to 
be  turned  to  good  account,  should  not  be  allowed  to  lay  the 
foundation  of  a  routine  practice,  but  should  rather  be  made 
available  as  helps  in  the  selection  of  the  proper  homoeopathic 
remedy,  or  as  helps  in  mechanical  or  surgical  appliances  or  inter- 
ference common  alike  to  homoeopathy  or  allopathy.  As  diseases 
of  the  knee-joint  were  not  of  every   day  occurrence  in  the 


142      Dr.  RaTisford  an  sorne  Affections  of  the  Knee-Joint 

ordinary  run  of  practices,  the  opportunity  for  their  study  was  not 
as  groat  as  many  other  aibnents.  No  doubt  an  interesting  dis- 
cussion might  be  brought  about  by  introducing  the  treatment  of 
scrofula,  but  that  would  be  travelling  out  of  the  legitimate  sphere 
of  the  paper.  The  disease  of  the  knee  that  most  frequently  came 
under  his  (Dr.  Drury's)  observation  was  housemaid's  knee ;  in 
tliat  affection  he  found  Bryonia,  Ehus,  and  SiUcea  most  valuable 
medicines.  In  scrofulous  affections  of  the  joint  many  of  our 
homoeopathic  remedies  possessed  wonderful  power.  Amongst 
others,  Assafoetida  was  one  well  worthy  of  attention. 

Dr.  KussELL  said  it  seemed  to  him  very  strange,  that  the  attend- 
ance at  our  meetings  appeared  to  be  the  inverse  proportion  to  the 
practical  character  of  the  paper  announced  to  be  read.  The  more 
theoretical,  the  more  interesting  apparently.  Tliis  he  regretted ;  for 
such  a  paper  as  has  just  been  read  is  of  the  highest  importance,  and 
might  elicit  much  useful  information  if  fully  discussed  by  those 
who  had  large  experience  in  this  class  of  aflfections,  which  gene- 
rally fell  to  the  lot  of  surgeons.  There  were  three  different  classes 
of  affections  of  the  knee-joint  which  were  apt  to  be  mistaken  for 
one  another — the  scrofulous  inflammation  of  the  tissues  of  the 
joint,  the  rheumatic  inflammation,  and  what  had  been  called  the 
hysterical  knee-joint.  He  had  had  very  well-marked  examples 
of  each  under  his  care  at  the  same  time,  and  in  all  of  them  he 
had  succeeded  in  effecting  a  cure  after  the  patients  had  been 
recommended  to  have  amputation  performed,  at  least  in  the  two 
former  cases.  In  the  hysterical  it  might  have  been,  for  the  case 
had  been  treated  as  one  of  white  swelling  of  the  knee-joint.  In 
the  first  case  SUicea  was  the  great  remedy,  and  the  case  resulted 
in  anchylosis  of  the  joint,  after  an  illness  of  fifteen  years.  In  the 
second  case  of  excessively  severe  rheumatic  gonitis,  Mercurius 
was  the  chief  medium  employed,  and  the  cure  was  completa 
In  the  third  case,  although  there  was  no  danger,  yet  it  proved 
tedious  and  troublesome,  and  got  weU  as  such  cases  do,  quite 
suddenly  and  unexpectedly. 

Mr.  Yeldham  said  some  of  Dr.  Hansford's  cases  referred  to 
Synovitis,  which  he  (Mr.  Yeldham)  considered  the  most  curable 
form  of  joint  disease.  The  knee  was  the  joint  most  commonly 
affected,  and  next  to  that,  perhaps,  the  wrist.  A  very  interesting 
point  in  the  history  of  these  cases  was  the  rapidity  with  which 
considerable  quantities  of  synovial  fluid  often  became  effused, 
and  the  almost  equal  rapidity  of  its  absorption.  He  had  recently 
treated  a  case  of  this  kind  in  a  lady,  who  caught  cold  whilst  gar- 
dening, and  in  whom  the  left  knee-joint  became,  in  a  few  hours, 
inflamed,  painful,  and  greatly  distended  with  fluctuating  fluid. 
Under  the  influence  of  rest,  cold  water,  and  Aconite  and  Mercu- 
rius, the  fluid  was  all  absorbed  in  three  days.    A  similar  case  had 


Dt,  Hansford  on  some  Affections  of  the  Knee^oinL       143 

lately  been  under  his  care  in  one  of  the  female  wanls  upstairs. 
Such  cases  were  very  frequent  and  were  satisfactory  in  their  results. 
Perfect  rest  was  very  important  in  joint  aff'ections.  lie  had  recently 
discharged  a  case  of  synovitis  of  the  wrist,  in  a  young  woman 
from  the  country.  Her  wrist  had  been  bad  for  18  months,  but 
she  had  been  aUowed  to  hang  the  limb  down,  and  it  had  not 
been  steadied.  It  was  very  painful,  and  filled  with  fluctuating 
synovia.  He  (Mr.  Yeldham)  placed  the  forearm  and  hand  on  a 
splint,  applied  cold  water,  and  gave  Calcarea  and  Sulphur,  and  in 
three  months  she  was  well.  Position  was  in  some  cases  scarcely 
less  important  than  rest.  This  was  well  illustrated  in  a  case 
which  was  sent  into  the  Hospital  about  three  years  since  from 
Nice  by  their  colleague  Dr.  Blest.  It  was  that  of  a  lady's  maid, 
who  had  inflammation  of  the  foot  and  ankle.  She  had  been  unable 
to  use  the  limb  for  many  months  previously,  and  had  been  treated 
allopathically  with  leeches,  &c.  After  her  admission,  she  was 
kept  in  bed  in  the  ordinary  recumbent  position.  This  and  medi- 
cines did  but  little  good.  He  (Mr.  Yeldham)  then  had  the  limb 
placed  on  an  inclined  plane,  considerably  elevated  at  its  distal 
end;  the  foot  thus  becoming  the  highest  part  of  the  body. 
Instant  amendment  followed,  and  she  speedily  recovered.  In- 
flammation of  the  ligaments  and  tendons  of  joints,  arising  com- 
monly from  sprains,  he  had  often  found  to  be  a  very  troublesome 
complaint ;  and  he  had  not,  in  his  practice,  generally  been  so 
fortunate  in  the  recovery  of  his  patients  as  the  author  of  the  paper 
had.  He  had,  at  that  time,  under  care  a  young  gentleman  who 
had  sprained  his  knee  in  jumping.  He  had  been  under  treatment 
a  month  already,  and  notwithstanding  that  he  had  rested,  and 
applied  Arnica,  and  Ehus,  and  cold  water,  and  taken  medicine 
internally,  the  inflammation  still  lingered  obstinately  about  the 
joint.  Of  scrofulous  afifections  of  the  joint — a  wide  field,  he 
would  not  then  say  anything.  Dr.  Kussell  had  alluded  to 
aflfections  of  the  joints  in  hysterical  subjects.  He  (Mr.  Yeldham), 
some  years  since,  had  under  care  a  very  remarkable  case  of  what 
might  perhaps  be  called  nervous  disease  of  the  hip.  It  occurred 
on  a  young  lady  who  had  been  strictly  confined  to  the  recumbent 
posture,  on  her  back,  for  five  years  before  he  saw  her.  During 
that  period,  she  had  never  left  her  bed,  nor  the  horizontal  posi- 
tion. The  afi'ected  limb  was  kept  straight,  and  was  steadied  by 
sand-bags,  the  least  motion  causing  intense  pain.  The  limb  was 
shortened,  and  in  other  respects  looked  like  genuine  hip-joint 
disease.  She  had  been  seen,  from  first  to  last,  by  many  eminent 
suigeons  and  physicians,  and  amongst  them,  at  his  (Mr.  Yeldham's) 
request,  by  their  President,  Dr.  Quin.  Ultimately,  it  was  deter- 
mined to  remove  her  to  the  seaside.  Her  bed  was  placed  in  an 
invalid  carriage,  and  she  was  carried  to  Brighton.     She  there 


144  Retrospect  of  1862. 

heard  of  the  late  Mr.  Hamip,  the  rubber.  He  took  her  in  han 
At  the  eud  of  three  months  she  could  walk  a  mile.  She  gotpe 
fectly  well,  has  since  married,  and  is  now  in  robust  health.  I 
should  state  that  there  was,  in  this  case,  no  abscess,  and  that  tl 
patient's  general  health  was  tolerably  good  throughout.  This  w 
clearly  not  a  case  of  idceration  of  the  joint :  but  most  probab 
one  of  chronic  iiiflanmiation,  or  nervous  irritation,  in  the  muscl 
and  parts  sun^oimding  the  joint.  Mr.  Yeldham  thanked  I 
Eansford  for  Ids  very  practical  paper,  and  regretted  there  we 
not  more  members  present  to  hear  it 


EETROSPECT    OF  1862. 


Translated  from  the  Allgemeine  Horrumpathische  Zeitung- 
slightly  abridged.  By  Dr.  Meyer,  Corresponding  Member 
the  Society. 
The  fifty  years*  war  does  not  slacken,  but  maintains  itsc 
fresh,  and  acquires  new  force.  Who  knows  whether  we  hi 
not  relaxed  our  efforts  and  accepted  a  compromise,  as  indeed 
sometimes  indicated  and  recommended  in  whispers  among  i 
if  our  opponents  were  not  for  ever  renewing  their  challenge 
Who  knows  whether,  satisfied  with  our  Homoeopathy,  such  as 
was  and  is,  we  had  not  entirely  abandoned  all  progress  and  t 
effort  to  increase  the  productions  of  our  inheritance  if  we  hi 
been  permitted  to  settle  in  peaceful  and  friendly  relations  wi 
our  opponents  ?  Had  we  done  so,  it  is  possible  that  th 
would  openly  have  acknowledged  what  they  now  secret 
borrow  from  us,  and  even  made  the  admission  that  there  w 
truth  concealed  in  our  doctrines.  But  could  this  appare 
felicity  have  long  endured,  if  each  of  us  had  maintained  wi 
was  most  distinctive  between  us  ?  Should  we  not  have  ma 
to  them  many  little  concessions,  and,  were  it  even  for  comp 
ment  sake,  should  we  not  have  admitted  that  many  of  th( 
therapeutical  principles  were  not  altogether  objectionable  ?  A] 
what  would  have  been  the  result  of  this  hypocritical  reciprocit; 


Retrospect  of  1802.  145 

Our  opponents  might  perhaps  have  learnt  something  from  ns ; 
but,  at  the  very  least,  we  should  have  introduced  impure  elo- 
ments  into  our  science,  which  might  have  undermined  it  a 
stability.  But  the  greatest  mischief  which  would  have  resulted 
from  80  false  a  fraternisation,  would  have  been  the  jmralysiiij,' 
influence  it  would  have  exerted  upon  our  efforts.  We  might 
still  have  laboured,  but  without  the  requisite  zeal ;  we  mijjht 
have  striven  forward,  but  not  with  the  openness  the  occasion 
required,  and  gradually  the  poison  of  lukewarmness  and  indo- 
lence would  have  penetrated  our  veins,  and  Homrjeopathy,  in- 
stead of  advancing,  would  have  retrograded. 

To  begin  our  retrospect  with  our  litemture :  we  see  how  it 
accumulates  from  month  to  month,  and,  if  everything  wliicli  is 
offered  to  supply  the  demand  is  not  of  great  worth  and  value, 
nevertheless  almost  every  literary  effort  demonstrates  the  desire 
of  its  author  to  do  some  real  service  to  our  cause.  Our  journals 
are  always  full,  and  manifest  that  there  is  no  deficiency  of  an 
earnest  power  of  labour. 

Our  book  of  books  is  the  Materia  Medica ;  to  it  belongs  the 
first  place  in  the  muster-roll.  None  of  his  followers  have  done 
so  much  for  it,  and  of  such  noble  quality,  as  the  foimder  of  our 
school  He  designed  the  general  plan  according  to  which  all 
future  efforts  were  directed.  To  this  work  every  new  cycle 
affords  its  new  contribution  of  material ;  the  year  just  passed 
has  considerably  enriched  this  department.  Among  others,  we 
have  to  mention  a  second  proving  of  Ehus  radicans,  left 
behind  by  our  deceased  colleague,  Dr.  Joslin,  of  New  York  ;  a 
proving  of  Plectranthus  fructuosus,  by  Von  Pratobevera ;  and 
an  arrangement  new  in  our  literature  of  the  physiological,  pa- 
thological, and  therapeutical  properties  of  Gelseminum  nitidum, 
by  our  indefatigable  colleague,  Constantin  Hering.  The  mani- 
fold and  deeply  working  effects  which  seem  to  be  peculiar  to 
this  plant,  would  well  repay  the  labour  of  a  regular  physiolo- 
gical proving.  Phosphorus  has  been  proved  over  again  by 
Soige,  and  the  results  exhibited  in  a  schema  in  our  monthly 

10 


146  Retrospect  of  1862. 

number,  which  also  contained  that  of  sulphur,  by  Wunnb,  ar- 
ranged by  Kraehe.  In  addition  to  these,  Opium  has  been 
revised  by  the  Austrian  Society  of  Homoeopathic  Physicians, 
which  is  now  inviting  assistance  towards  another  proving  of 
Ledum  palustre;  while  Hoppe  has  undertaken  a  proving  of 
Chamomilla;  and  Szontagh,  one  of  Arnica.  Fragmentary 
provings  of  Lycopodium  have  been  contributed  by  Baum- 
giirtner;  and  of  Veratrum  album  and  Helleborus  niger,  by 
Lembke.  Valuable  and  welcome  as  all  repetition  of  provings 
are,  yet  they  are  all  deficient  in  the  most  important  atfribute, 
towards  which  we  have  akeady,  although  unfortunately  in  vain, 
directed  attention.  The  object  in  repeating  a  proving  is  two- 
fold,— the  discovery  of  new  powers,  and  the  confirmation  of 
symptoms  already  detected  by  former  provers.  But  that 
these  results  may  be  clearly  discerned  and  become  of  practical 
utility,  it  is  the  duty  of  those  who  have  undertaken  the  task  to 
indicate  clearly  and  sharply  which  are  the  new  and  which  are 
the  old  and  confirmed  symptoms.  The  latter  are  the  most 
important,  for  such  a  confirmation  of  the  former  symptoms 
establishes  their  certainty,  and  would  warn  off  as  a  "  noli  me 
tangere  "  the  most  rabid  erasers  and  correctors.  But  if  those 
engaged  in  this  work  of  repeating  provings  leave  this  separation 
to  the  judgment  of  their  readers,  the  design  of  their  whole 
labour  has  miscarried,  for  they  will  only  be  laid  aside  as 
valuable  material  for  future  use.  If  then  those  who  undertake 
this  proving  over  again  wish  to  accomplish  some  material 
advantage,  they  should  not  shun  this  slight  additional  trouble, 
which  would  be  their  best  recompense  for  their  self-devotion. 

Whatds  called  the  purification  of  our  Materia  Medica,  which 
is  said  to  be  so  much  desired,  has  been  but  little  attended  to. 
Veratrum  album  alone,  which  had  already  been  sifted  by  Gerstel 
has  been  subjected  to  the  critical  examination  of  the  industrious 
Eoth.  But  here  too  we  miss,  with  regret,  the  exposition  of  the 
final  result, — we  mean  the  definite  conclusions — what  syniptoms 
are  to  be  irrevocably  expunged  from  the  Hahnomannian  proying, 


Retra9p,rt  //  IRfii'.  147 

what  are  to  be  retained  only  provisionally,  and  what  ar<'  to  bo 
regarded  as  so  established  that  they  are  never  to  h(»  nn.ddlnl 
with.  This  determination  is  as  indispensable  as  we  have  shown 
it  to  be  in  the  case  of  the  re-proving  of  medi<'in<»s,  <»thiTwise  tin* 
labour  bestowed  npon  such  a  purgation  has  ])0<'n  ])artiall\'  at 
least  in  vain.  At  all  events  such  an  undertakin<^  is  no  light 
task,  and  at  all  events  utterly  impracticable  for  any  sin^^'lo  i»*r- 
son.  We  willingly  acquiesce  in  the  proposal  recently  ina<h*  by 
Langheinz,  that  a  society  should  be  instituted  whicli  sh  )ul«l 
undertake,  by  the  co-opemtion  of  its  meml)ers,  the  sifting  of  our 
Materia  Medica.  But  the  primary  condition  of  siu-li  an  associa- 
tion, from  which  anything  of  real  use  was  to  be  expoct<^d,  is  not 
the  formation  of  any  external  fomis  of  construction,  much  less 
that  there  should  be  set  forth  a  regidar  progmmme  and  a  set  of 
rales,  according  to  which  all  citations,  and  the  so-called  "  o])ser- 
vations  of  others,"  should  be  tested ;  but  what  is  wanted  is,  that 
the  pathogenesy  arrived  at,  through  the  physiological  proving, 
should  first  be  taken  in  hand  and  thoroughly  examined, — and 
this  seems  to  us  by  far  the  most  important  \)tiYt  of  the  umh.T- 
taking.  Some  kind  of  programme,  however,  is  rccpiired,  tliat 
everyone  who  wishes  to  join  the  association  may  weigh  before- 
hand whether  he  is  competent  to  fulfil  the  reciuisitc  conditions 
implied  in  the  execution  of  the  task.  For  nowhere  is  it  more 
necessary  to  work  according  to  a  predetermined  arrangement ; 
in  nothing  could  more  harm  arise  from  the  admission  of  arbi- 
trary and  individual  views,  than  in  this  work  of  critical  purifi- 
cation. When,  however,  such  a  plan  is  being  formed,  the  first 
requisite  of  those  who  undertake  the  w^ork  will  be,  that  they 
regard  the  thorough  sifting  of  our  Materia  IVIedica  as  the  most 
important  requisition  of  our  science.  We  may,  perhaps,  have 
occasion  to  recur  more  in  extenso  to  this  matter ;  at  present  w(» 
must  content  ourselves  with  the  expression  of  this  hope,  that 
for  such  an  association  only  those  be  selected  who  are  known  to 
be  practical  as  well  as  theoretical,  and  who  are  thoroughly  versed 
in  out  Materia  Medica,  and  know  how  to  appreciate  its  gieat 

10* 


1-48  Eetrospect  of  1862. 

worth  ;  but  sceptics,  or  nationalists,  as  it  is  the  fashion  to  term 
thorn  now-a-tlays,  are  not  adapted  to  so  grave  and  important  a 
task,  for  in  this  matter  so-called  Eeason,  as  it  dealt  its  strokes, 
niiglit  play  many  a  foolish  prank  and  strike  out  at  random.  Of 
this  we  have  abundant  examples,  but  at  all  events  we  would 
strongly  recommend  to  the  attention  of  those  who  propose  to 
engage  in  the  task,  the  few  but  pregnant  words  spoken  by  Dr. 
Gross,  of  Barmen,  that  hitherto  all  the  attempts  at  revision  of 
provings  have  consisted  chielly  in  criticising  quotations  of  historical 
or  personal  grounds,  and  have  dealt  with  what  is  external  in  re- 
ference to  the  provings  tliemselves,  or  to  the  persons  who  were 
engaged  in  making  them,  but  have  neglected  to  observe  the  in- 
ternal physiological  harmony  of  the  different  groups  of  symptoms. 
Nothing  is  easier  than  making  erasures,  but  we  openly  avow, 
that  we  should  rather  retain  twenty  false  symptoms,  than  see  a 
single  true  and  trustworthy  one  erased  :  an  erroneous  symptom 
may  mislead  us,  but  to  deprive  us  of  a  trustworthy  symptom  is 
to  commit  an  act  of  robbery  upon  us  and  our  science.  Hence 
it  needs  the  exercise  of  the  greatest  prudence  and  circumspec- 
tion in  the  choice  of  means  and  ways,  which  are  proposed  for 
adoption,  and  in  the  choice  of  the  men  to  whose  hands  we 
commit  such  sharp-cutting  instruments. 

Nor  can  we  report  much  more  progress  than  in  the  depart- 
ment we  have  just  referred  to  in  the  elaboration  of  our  Materia 
Medica.  Among  those  wliich  have  appeared  in  this  journal  we 
may  notice  a  composition  exhibiting  the  action  of  Glonoine,  and 
a  scientific  arrangement  of  the  effects  of  Calcarea  and  of  Aga- 
ricus  muscarius,  taken  from  the  excellent  work  of  Espanet, 
entitled  "  Traits  m^thodique  et  pratique  de  Materia  McJdicale 
et  de  Thdrapeutique,"  a  book  we  strongly  recommend  as  worthy 
of  study  by  those  who  are  masters  of  the  French  language. 

Close  upon  the  territory  of  the  Materia  Medica  stand  the 
observations  and  experiments  in  pharmacodynamics.  We  shall 
begin  with  the  little  that  has  been  done  in  this  department  by 
homoeopathic  physicians.      Pemerl  gives   an  account  of  the 


Rdrmpect  of  1862,  149 

action  of  Atropin,  which  he  employed  in  the  dose  of  1-3 2nd 
part  of  a  grain,  as  a  subcutaneous  injection  in  a  case  of  proso- 
palgia. Gallavardin  rei)orts  upon  the  efle('ts  of  l^hosphorua 
upon  the  nerves  of  sensation  and  of  motion,  upon  tlie  latter  of 
which  this  medicine  exerts  a  i)amlysing  inlhience.  Kotli  details 
many  interesting  effects  of  Curai'o,  Nicotine,  irEtlur,  and 
AlcohoL  Severa.1  additional  conclusions  in  regard  to  Huiti 
Brasiliensis  and  Cocco  are  given  in  tlie  letters  on  Xatnnil 
History  which  have  been  published  in  this  journal.  l^ahaps 
we  ought  to  include  in  this  list  the  experiments  ma  le  l)y 
Hoppe  with  Oil  of  Turpentine,  which  he  api)lied  heated  to  the 
skin,  and  produced  all  the  symptoms  of  a  bum.  But  more 
important  than  these  are  the  contributions  of  our  allopathic 
brethren  to  pharmacodynamics,  which  appi^ared  in  our  nn'nthl} 
part.  Most  of  these  were  histories  of  casrs  of  poisoning.  An 
acute  case  of  poisoning  with  PhospJioincs  is  detailed  by  Ehrle 
and  Wagner;  with  Petroleum,  by  Jelliuek ;  with  Arseni\  by 
Custer;  with  StraTnonium,  by  Flogel,  Konty,  and  Beniliard; 
with  Solanum  nigrum,  by  the  same  authorities;  with  Chlornft  mi, 
by  Lamm ;  with  Upas  tieut^,  by  Mannkopf,  who  likewise  re- 
lates a  series  of  cases  of  poisoning  with  Sulphuric  Acid,  wliicli 
report,  besides  containing  other  interesting  symptoms  produced 
by  Sulph^cric  Add,  makes  special  mention  of  its  exciting  au 
intercostal  neuralgia.  By  experiments,  but  chiefly  upon  animal.^, 
the  physiological  effects  of  Colchic^tm  have  been  ascertained  by 
GoupU;  the  action  of  Quassia  upon  the  irritable  tissue  (irri- 
tablen  Grewebe),  and  oiNatrum  muriaticicm,  by  Hoppe ;  of  Vcrrr^ 
tnmi  mi%de,  by  Cutler  and  others ;  of  Glo7wine,  by  Demme ;  of 
Digitalin,  by  Stadion  (a  most  valuable  work) ;  of  Caffeine,  by 
Biill;  of  Berherin  and  Ilicin,  by  Albers;  of  Alcolwl,  by 
LaUemand,  Perrin,  and  Duroy;  and  lastly,  on  the  peculiar 
action  of  the  Secale  coimutum — a  contribution  to  our  pages  by 
Theod.  Meyer,  of  Mietau,  the  substance  of  which  he  probably 
obtained  from  a  Eussian  journal. 

As  yet  no  inspired  prophet  has  appeared  to  give  us  a  final 


150  Retrospect  of  1862. 

decision  upon  the  contested  questions  in  regard  to  the  dose. 
However,  if  any  one  expects  that  this  problem  will  be  solved 
in  any  such  miraculous  way,  he  wiU  find  himself  much  mis- 
taken. What  is  here  required  is  individual  effort  and  indi- 
vidual observation ;  any  one  who  shuns  these,  or  believes  them 
to  be  superfluous,  is  incompetent  on  this  important  matter.  It 
is  only  by  exact  experimentation  and  persevering  and  unpreju- 
diced observation,  that  the  reading  of  this  riddle  can  be  obtained, 
while  prejudices  and  prepossessions  make  the  confusion  greater. 
Happily,  these  unhealthy  peculiarities  disappear  more  and 
more,  and  the  small  party  which  attempts  to  stifle  the  whole 
inquiry  by  certain  phrases,  shrivels  daily  into  even  smaller 
dimensions.  Even  they  now  seek  to  attach  themselves  to  the 
larger  body,  aware  of  the  danger  to  their  very  existence  as  a 
party  if  left  wholly  isolated.  Our  science  is  the  sworn  foe  of 
the  materialistic  medicine  of  the  present  day,  and  any  one  who 
admires  the  latter  cannot  duly  appreciate  the  former.  Smallness 
of  dose  is  one  of  the  essential  doctrines  and  principles  of  Homoeo- 
pathy, and  it  is  only  as  to  the  degree  of  smallness  that  there 
can  be  discussion  among  us.  A  previous  year  has  afforded  us 
a  contribution  of  both  a  practical  and  theoretical  character. 
The  practical  is  given  in  a  communication  by  Eidherr,  contain- 
ing a  collection  of  cases  of  pneumonia,  treated  by  a  methodical 
administration  of  different  doses,  the  conclusion  from  which 
was,  that  the  most  favourable  results  were  obtained  from  the 
highest — the  30th  dilution.  The  hypothetical  reflections  and 
objections  suggested  against  this  result  by  Schneider  have  as 
little  weight  against  the  facts  as  do  the  four  conclusions  he 
su))joins  succeed  in  winning  our  assent.  How  unwarranted  is 
the  assumption  of  Schneider  and  others,  that  in  acute  cases  the 
larger  doses  alone  are  proper,  is  demonstrated  by  Battmann,  who 
details  a  case  of  Angina  membranacea  cured  by  the  high 
dilutions;  and  the  cure  is  so  striking,  that  the  action  of 
the  high  potencies  of  the  medicines  in  this  acute  disease 
is  not  attempted  to  be  denied  by  the  leaders  of  the  sceptics. 


Retrospect  of  1862.  lot 

and  only  glossed  over  by  an  exclamation  of  siiriiviMo.  Aegidi 
also  spoke  in  favour  of  the  high  potencies,  and  att(.>n)i»tcMl  to 
explain  the  nature  of  their  effects  by  their  analo-ry  with  the 
imponderables.  Dr.  Grauvogl  lias  written  ui)on  the  aritlnnetical 
and  physical  relation  of  the  different  dilutions.  On  tlie  otln*r 
side,  the  deceased  Gaspary  believed  hinis^'lf  called  to  |:ive,  for 
the  advantage  of  others,  his  reflections  and  experiences  u])on 
the  doses  of  the  Materia  Medica;  and  in  tlicse  he  makes  special 
reference  to  a  conversation  with  Hahnemann.  Eecallinir,  how- 
ever, to  our  minds  the  well-meaning  proverb,  "De  niortuis  nil 
nisi  bene,"  we  refrain  from  passing  a  judgment  upon  tlicse 
reflections  and  experiences  of  our  depai-ted  colleague.  The 
different  views  entertained  ui)on  the  question  of  the  dos**  which 
were  brought  before  the  Vienna  Society  by  its  desire,  are  to  be 
found  arranged  by  Eidherr;  and  lastly,  Huber,  of  Klagcnfurth, 
brought  forward  proofs  (for  the  most  part  already  cited),  derived 
from  animate  and  inanimate  nature,  of  the  positive  effects  of 
infinitesimal  quantities.  The  most  important  addition,  how- 
ever, to  this  department  were  the  experiments  to  which  Ozanam 
subjected  our  preparations  by  means  of  the  spectrum  analysis, 
by  which  he  demonstrated  the  presence  of  the  material,  even  in 
the  higher  potencies.  It  is  to  be  hoped  that  he  will  persevere 
with  his  course  of  experiments. 

Firmly  established  as  the  principles  of  Homoeopathy  are,  yet 
we  do  well  to  be  careful  to  exhibit  in  a  clearer  light  how 
entirely  rational  and  consistent  with  nature  are  the  premisses  of 
our  system,  by  a  constant  reference  to  the  advance  of  scientific 
investigation  and  observations  in  other  departments  of  natural 
science.  Towards  this,  in  former  years,  our  greatest  contributor 
was  Hoppe.  Supported  upon  his  well-known  vascular  theory, 
which  was  farther  elaborated  in  an  article  entitled  "How 
do  the  blood-vessels  comport  themselves  in  the  process  of  resto- 
ration ?"  he  treated  of  the  essence  and  of  the  limits  of  Homoeo- 
pathy— of  the  doctrines  of  Hahnemann,  that  the  substance 
which  produces  a  disease  has  the  power  of  curing  the  same ; 


152  Retrospect  of  1862. 

and  he  strove  to  establish,  in  a  scientific  and  highly  ingenious 
method,  the  proper  indications  afforded  by  the  subjective 
symptoms,  and  the  gradual  transition  into  improvement  and 
restoration  effected  by  the  medicines.  It  is  certain  that  this 
vascular  theory,  the  truth  of  which  Hoppe  has  striven,  by 
many  experiments,  to  demonstrate,  is  calculated  to  afford  con- 
clusions in  regard  to  many  physiological  and  pathological 
processes,  and  most  especially  upon  the  action  of  homoeopatliic 
medicines  and  their  doses :  but  to  our  mind  it  is,  on  the  one 
hand,  too  wide,  leaving  so  many  ambiguities,  and,  on  the  other 
hand,  too  narrow,  while  it  fails  to  explain  the  law  of  the  more 
delicate  specific  effects  in  the  sphere  of  the  action  of  the 
medicines.  In  the  meantime,  however,  our  best  thanks  are 
due  to  this  indefatigable  and  diligent  inquirer,  and  we  hope 
that  his  exertions  and  labours  will  be  justly  appreciated.  In 
the  same  department  we  have  to  mention  an  article  by 
Schneider,  of  Magdeburg,  on  the  physiology  of  disease  and 
cure.  The  learned  V.  Bonninghausen  has  directed  his  atten- 
tion, in  his  solid  style,  towards  the  importance  of  the  anamnesis 
in  the  treatment  of  diseases,  and  especially  of  sycosis.  By  the 
citation  of  the  medicines  which  agree  with  Thuya  in  the 
symptoms  of  sycosis,  he  seeks  to  enlarge  to  a  considerable 
extent  the  range  of  our  anti-sycotic  remedies.  The  same 
author  presents  us  with  a  small  work  on  the  indications  afforded 
by  the  aggravation  of  pain  and  sensibility  induced  by  move- 
ment or  by  repose,  and  thus  exhibits  the  mistake  the  younger 
Homoeopaths  commit  when  they  regard  such  apparently 
trilling  symptoms  and  distinctions  as  unworthy  of  their  atten- 
tion. In  a  separate  treatise,  entitled  "  Homoeopathy  and  Hah- 
nemann," fuU  of  piety  and  manly  rectitude,  Hencke  has,  in 
logical  order,  arranged  all  the  doctrines  of  Hahnemann.  Such 
a  work  as  this  was  the  more  demanded  because  the  young 
Homoeopathists  now-a-days,  unfortunately,  are  unwilling  to 
go  back  to  the  original  sources,  and  our  new  guide-books  to 
Homoeopathy  exhibit  the  doctrines  in  a  too  flashy  and  super- 


Retrospect  of  18r>2.  153 

ficial  a  style.  It  is  for  this  reason  we  wish  most  emphatically 
to  reconunend  the  work  named  above.  On  the  primary  and 
secondary  action  of  medicines,  and  on  the  alternation  of 
medicines,  Gross,  of  Barmen,  has  expressed  his  opinions.  In 
regard  to  the  proposition  frequently  tliscussed  in  fonnur  years, 
of  the  rebaptism  of  Homceopathy,  we  have  this  year  sucli  men 
as  Hering,  link,  and  Stem  expressing  a  most  unc|iialilied  dis- 
approval    We,  too,  exclaim  against  this  anahaptism. 

Let  us  now  dii-ect  our  attention  to  the  practical  departments 
of  our  science.  The  first  work  we  here  encounter  is  Kiickert's 
important  collection  of  cases,  entitled  "  Clinical  Experiences," 
the  first  volume  of  which  appeared  in  the  year  1854,  and  which 
arrived  at  a  provisional  conclusion  in  the  fourth  volume  recently 
published ;  whUe  the  publication  of  the  supplement  is  only 
retarded  by  external  obstacles.  In  the  meantime,  materials 
continue  to  accumulate,  and  the  year  that  has  just  passed  is  not 
less  rich  in  published  records  of  clinical  observations  than  its 
predecessors.  We  shall  not  attempt  the  particular  enumeration 
of  each  of  these,  because  the  task  would  be  too  laborious,  and 
the  space  required  beyond  what  we  could  spare ;  so  we  must 
limit  our  observations  to  those  narratives  of  cases  and  commu- 
nications which  are  of  special  importance  for  the  therapeutics  of 
certain  diseases.  Among  these,  Gerson's  experience  upon  the 
treatment  of  prosopalgia  was  most  instructive.  Unfortunately, 
this  excellent  work  is  hitherto  incomplete.  Schweikert  published 
his  observations  on  Cynanche  cellularis  Maligna,  against  which 
he  recommended  anthraxin  as  the  most  efficacious  remedy. 
Sigmann  wrote  upon  the  therapeutics  of  Leucorrhcea,  and 
pointed  out  the  necessity  of  a  local  examination.  Freytag 
treated  of  Amblyopia  in  its  pathological  and  therapeutical 
aspect.  Bartl  reports  upon  the  treatment  of  Ophthalmia  in 
general  and  of  Egystian  in  particular,  likewise  of  epilepsy  from 
his  previous  hospital  experience.  Stern  has  written  upon  the 
therapeutics  of  syphilis ;   Clotar  MUller,  on  Migrane ;  Quaglio, 


154  Retrospect  of  1862. 

upon  Laryngismus  stridulus  and  croup ;  Buchner,  aphoristically 
on  the  therapeutics  of  affections  of  the  diaphragm  of  Bright's 
disease  and  uraemia ;  Boyer,  on  his  treatment  of  metrorhagia ; 
Kidd,  upon  fibrous  tumours  of  the  uterus ;  Mclimmont,  upon 
pelvic  cellulitis,  against  which  dangerous  disease  he  recommends 
next  to  Aconite,  Veratrum  viride.  Besides,  Kraizell  conmiuni- 
cates  some  successful  cases  of  typhus  fever ;  and  Hirsch  describes 
his  experience  in  the  treatment  of  pauaritum,  and  writes  on  the 
prophylaxis  and  cure  of  abdominal  hernias  (unterleib  Hemien). 
The  discussion  which  took  place  at  the  annual  congress  of  the 
Central  Association  turned  upon  whooping-cough,  asthma  thy- 
micum,  and  epilepsy.  Finally,  Bruchner  drew  a  parallel  be- 
tween the  allopathic  and  homoeopathic  treatment  of  symptoms 
of  depression  and  paralysis,  while  Bresslauer  recommended  a 
judicious  employment  of  the  water-cure  to  Homoeopathists  in 
certain  cases.  We  have  also  to  mention,  as  of  especial 
worth,  a  treatise  by  Proll,  entitled  "Experiences  and  Studies  on 
Gastein,'*  which  exhibits  the  subject  from  various  homoeopathic 
points  of  view.  But  one  of  the  most  gratifying  publications  in 
this  province  was  the  commencement  of  a  work  on  homoeo- 
pathic therapeutics,  by  Bahr,  which  supplies  a  long  felt  want, 
and  upon  the  contents  of  which  we  have  already  expressed  our 
opinion.  The  treatise  of  Kafka  upon  the  same  subject  will  fall 
to  be  considered  in  the  retrospect  of  next  year.  The  following 
is  a  catalogue  of  the  certain  medicines  which  have  been  recom- 
mended against  certain  diseases  : — Phosphorus  against  Icterus 
7)ialignus,  by  Schaedler  and  Eavel ;  Apis  against  Morbus 
Brightii  and  scarlatina,  by  Teller ;  Arnica  in  poisoning  from 
adder's  bite,  by  Kirsten ;  Argentum  nitricum  against  chorea, 
by  Gross,  of  Eegensburg;  Bryonia  as  an  external  application  in 
arthritis  and  rheumatism,  by  the  deceased  Perrutz;  Glonoine 
against  certain  forms  of  brain  affections,  by  Kaeseman  and  Ganz ; 
Mercurius  iodatus  against  diphtheritic  sore-throat  in  scarlet'fever, 
by  Kirsch,  jun.;  Mercurius  corrosives  against  an  epidemic 
dysentery  by  Ellinger ;  Phospholeinum  against  impotence  and 


Retrospect  of  1862.  155 

bashfolness  in  youth,  by  Altschul  ;*  Ledum  palustre  against 
-whooping-cough — a  popular  remedy  in  Kussia — by  Lembke; 
the  differential  diagnosis  between  opium  and  glauber-solts  in 
lead-colic  is  shown  by  Gross,  of  Barmen ;  and  against  incipient 
tabes  dorsalis,  the  rubbing  in  of  the  lumbar  portion  of  the  spinal 
marrow  and  brain  of  a  pig  ;t  besides  Gelseminum  scmpervi- 
vens  against  apoplexy,  by  Hall ;  Eumex  crispus  against  lavi/n- 
geal  catarrh,  by  Joslin;  Agaricus  muscarius  against  chorea, 
by  Clifton  and  Bloede;  Kalmia  latifolia  against  rheumatism, 
by  Fretsch ;  and  Sarcenia  purpurea  for  the  rapid  cure  of  small- 
pox, and  the  avoidance  of  its  scai*s. 

The  following  articles  are  rather  of  pathological  than  of 
therapeutical  interest : — A  treatise  on  the  Asthma  of  IMsoners, 
by  Marschall ;  an  attempt  at  a  more  precise  demonstration  of 
the  causes  of  spasmodic  dyspnoea  of  children  and  adults;  an 
article  by  Freytag,  and  an  essay  by  Bohler,  upon  the  recog- 
nition of  the  existence  of  Trichia;  and  one,  by  Mayerhofer, 
upon  angina  diphtheritica.  Perhaps  we  should  include,  in 
this  list,  an  article  upon  the  Mischief  of  Vaccination,  by 
Graham. 

We  will  not  repeat  our  old  complaint  that  we  obtain  but 
little  from  our  clinical  institutions.  Much  as  this  is  to  be 
regretted,  yet  at  present  there  seems  little  prosi)ect  of  improve- 
ment, for  the  cause  lies  in  insufficient  remuneration  of  the 
physicians  and  their  assistants.  Tlic  Praxis  axtrca  must  be 
sought  outside  the  hospital,  and  thus  much  is  allowed  to  go  to 

*  The  German  text  is  Impotenz  wul  Blodigkeit  dor  Kinder, 
and  the  literal  rendering  would  be  "  impotence  and  bashfulness  of 
children."  What  this  means  is  beyond  the  conception  of  the 
translator. 

t  Again,  we  are  afraid  to  trust  our  senses  and  reproduce  the 
text  verbatim  et  litteratim — Die  verriebene  portio  lumbalis  der 
MedtUla  spinalis  und  cerdyt*i  Porci  gegen  beginnende  Ruckenmarh- 
Schwind'sucht:  it  may  mean  triturations  of  the  spinal  marrow 
and  brain  of  a  pig,  and  not  that  this  is  to  be  rubbed  in.  It  pro- 
bably does  not  much  signify  what  it  means. — Tr. 


156  Retrospect  of  1862. 

waste  within  our  institutions  which,  if  it  could  be  published, 
would  be  of  good  service  to  our  science.  So  we  must  content 
ourselves  with  the  little  afforded  us  by  our  hospitals  in  the 
year  1862.  We  have  first  to  mention  the  continuation  of  the 
report  of  the  hospital  at  Gyongyos,  by  Homer,  which  contains 
much  that  is  interesting.  Then  we  have,  from  the  industrious 
Eidlierr,  a  small  selection  of  clinical  cases  from  the  Homoeo- 
pathic Hospital  in  the  Leopoldstadt,  at  Vienna,  and  the  annual 
statistics  of  that  institution;  we  have  likewise  a  statistical 
report  on  the  hospital  at  Munich,  founded  and  conducted  by 
Buchner  and  Quaglio ;  and,  finally,  we  have  the  annual  report 
on  the  results  of  the  Leipzig  Dispensary,  which  Clot.  Mutter 
subjoined  to  the  treatise  on  migrim  of  which  mention  has 
already  been  made. 

When  we  have  mentioned  that  our  domestic  homoeopathic 
literature  has  been  enriched  by  a  most  useful  work  from  the 
pen  of  Altschul,  entitled  "  Eules  for  diet  and  prophylaxis  for 
ofi&cers  and  their  horses,"  Kkewise  by  Grauvogl,  and  by  a 
second  edition  of  Gullen's  "  Eepresentation  of  Homoeopathy," 
we  shall  have  completed  our  survey  of  the  scientific  contri- 
butions received  by  Homoeopathy  in  the  year  that  is  past. 
This  survey  would,  however,  have  been  much  more  extensive 
had  we  not  been  compelled  to  confine  it  to  our  own  literature, 
and  thus  to  exclude  the  contributions  of  the  foreign  periodical 
press,  some  of  which  have  been  translated  into  German,  as,  for  ex- 
ample, the  excellent  treatise  of  Veterinary  medicine  by  Pemisal 
Yet,  from  what  we  have  detailed,  every  reader  will  perceive 
that  our  little  circle  of  colleagues  have  not  been  idle,  but 
with  much  diligence  have  laboured  at  the  development  of  our 
glorious  science. 

A  further  proof  of  this  is  to  be  found  in  the  establishment 
of  two  new  homoeopathic  periodicals:  the  one  edited  by  Eidherr, 
entitled  "  Zeitschrift  des  Vereins  horn.  CErzte  (Esterreichs,"  and 
the  other,  "  Journal  du  Dispensaire  Hahnemann  de  Bruxelles," 
by  Mourcmans.      Both  these  journals  are,  doubtless,  welcome 


RetTos^pect  0/  186 2.  157 

to  our  reading  colleagues.  We  likewise  take  tliis  opportunity 
to  make  mention  of  a  periodical  publication  comnuMict'd  in 
1861,  imder  the  title,  Annals  of  the  British  Ilunueoitathic 
Society,  and  of  the  London  Homoeopathic  11  Oi^j) it al.  This  journal, 
which,  besides  containing  reports  of  tlie  tninsactions  of  tlie 
Society  and  showing  the  activity  of  the  London  Ilonicoopatliic 
Hospital,  possesses  other  points  of  interest,  affords  especially  a 
brilliant  proof  of  the  earnestness  and  scientific  sjarit  wln'cli 
pervades  both  the  Society  and  the  Hospital.  In  the  foi-mor 
there  are  very  full  and  often  most  instructive  discussions  u])on 
the  essays  read  before  the  meetings ;  while,  in  the  latter,  besides 
the  treatment  of  the  cases  admitted,  lectures  of  a  pathological 
and  therapeutical  character  are  delivered,  and  thus  no  pains  are 
spared  to  extend  a  knowledge  of  Homceopathy,  and  to  attract 
both  young  and  old  physicians.  And  this  devotion  is  shown 
not  to  be  in  vain  by  the  rapid  increase  of  Homceopathists  in 
England  from  year  to  year,  and  by  the  futile  attempts  made 
by  some  of  the  licensing  bodies  (especially  those  of  Ireland)  to 
induce  those  who  are  entering  the  profession  to  bind  themselves 
never,  in  their  whole  future  career,  to  tamper  with  the  great 
medical  abomination.  "  E  pur  se  muove  ! "  we  exclaim  to  these 
petrifying  institutions.  In  France,  too,  the  voice  of  the  de- 
fenders of  our  science  becomes  every  day  louder,  and  we  have 
in  view  especially  the  writings  of  Gallavardin,  who,  in  his  work 
entitled  "  Experiences  sur  les  Malades  des  Hopitaux  instituds 
par  TAcaddmie  de  Mddecine,"  condemns  the  tendency  of  the 
allopathic  hospitals,  and  the  frivolity  with  which,  in  a  country 
so  boastful  of  its  civilization,  hospital  patients  are  regarded  as 
the  material  for  bold  experiments.  Although  such  exposures 
may  be  received  by  the  mass  of  the  profession  only  with  a 
scornful  laugh,  yet  the  repetition  of  truth  makes  some  impres- 
sion on  the  conscience.  Lympha  cavat  lapidem  non  forte  sed 
80&pe  cadendo. 

We  have  also  to  notice  more  activity  among  the  Homceopathists 
of  Switzerland,  as  is  shown  by  their  congress  at  Alten,  and  their 


158  Retrospect  of  IQ&2. 

resolution  to  constitute  a  society  for  proving  medicines.  From 
far  distant  lands,  too,  we  hear  of  the  greater  spread  of  the  doc- 
trines of  Hahnemann.  From  the  Colony  of  Blumenan,  in  South 
Brazils,  we  received  a  report  from  Friedenreich  of  the  increasing 
adhesion  to  Homoeopathy  in  that  country.  He  likewise,  in  the 
most  handsome  way,  presented  to  the  congress  some  tinctures 
made  from  Brazilian  plants,  and  a  preparation  of  Trigonocepha- 
lus  jararaca.  While  from  Chili,  Garcia  Fernandez  sends  us  an 
account  of  the  extension  of  our  system,  from  Smyrna  we  hear 
of  its  progress,  by  the  pen  of  Cricca ;  and  among  many  other 
sources  of  intelligence,  showing  the  strong  hold  it  has  got  in 
Melbourne,  we  may  mention  the  reports  of  V.  Eochlitz. 

If  we  now  survey  our  own  German  fatherland,  we  have  not 
so  much  to  tell  of  the  increased  extension,  of  the  elevation  or 
the  augmented  reputation  which  our  science  has  here  obtained. 
Before  there  is  much  improvement,  the  prevailing  school  of 
medicine  must  work  itself  clearer  of  its  present  gross  material- 
ism ;  perhaps,  however,  the  day  is  not  so  distant,  when  the 
physicians  will  again  learn  to  think.  In  this  period  of  expecta- 
tion we  must  not  let  our  hands  hang  idly  by  our  side,  but  we  should 
carefuUy  watch  all  the  movements  of  our  antagonists  with  a 
careful  eye,  so  as  to  parry  with  the  requisite  adroitness  every 
attack  from  whatever  side  it  may  come.  We  have  to  thank 
this  watchfulness  and  tact  for  converting  into  a  triumph  for  our 
cause  the  movement  in  Prussia  against  freedom  in  dispensing 
medicines.  The  result  of  their  aggression  is  that  a  ministerial  order 
has  been  issued  enlarging  instead  of  abridging  our  liberty  in  this 
matter.  The  association  for  establishing  a  homoeopathic  hospi- 
tal in  Berlin  has  made  good  progress,  and  besides  the  regular 
subscriptions,  has  been  enriched  by  some  handsome  benefactions. 
The  project  has  our  best  wishes  for  its  success.  There  is  some 
mitigation  of  the  repressive  enactments  against  Homoeopathy  in 
Bavaria,  under  the  regime  of  the  present  more  liberal  govern- 
ment. 

To  the  credit  of  the  Bavarian  homoeopathic  physicians,  let  us 


Retro^ct  of  1862.  inji 

record  that  out  of  their  private  means  they  have  contributoil  a 
fand,  out  of  which  the  assistants  at  Buchnor's  Hospital  may  l»e 
paid  a  salary.  In  other  respects  there  is  little  change  in  Ger- 
many, and  when  Frolitz  asks,  "  How  goes  the  time  in  tlie  king- 
dom of  legitimate  state  medicine  ?"  we  might  reply,  it  is  liigli 
time  for  it  to  begin  to  reform  itself,  lest  the  people  should  them- 
selves undertake  the  task  :  for  already  the  matter  is  being  taken 
in  hand  by  the  Social  Science  Association  (volkswii-thschaftliche 
Verein),  which  has  secured  greater  freedom  for  physicians,  and 
has  done  away  with  their  dependence  upon  the  apothecaries 
(chemists).  Thus  Homoeopathy  leads  the  van  in  the  march  of 
external  liberation.  Let  us  stand  shoulder  to  shoulder  and  en- 
dure the  toil  and  the  struggle.  What  we  cannot  achieve  by  indi- 
vidual effort,  must  be  done  by  associative  strength ;  and  it  was 
a  happy  idea  of  our  Central  Society  of  Homoeopathic  Physicians, 
to  send  delegates  both  to  the  Congress  of  Naturalists  at  Carlsbad, 
and  the  Congress  of  Social  Science,  at  Weimar.  Fischer,  of 
Weingarten,  Forges,  and  Hoppe  have,  with  much  tact  and  ani- 
mation, fulfilled  this  mission.  We  would  express  both  to  these 
colleagues  and  to  the  Central  Association,  our  thanks  for  the  steps 
they  took  on  this  occasion,  and  also  our  wish  that  the  partici- 
pation in  the  meetings  of  the  two  cliief  German  Societies — the 
"  Central  Vereiu,"  and  the  "  Vereinigung  der  Homoop.  (Erzte 
Bheinlands  und  Westphaliens" — may  steadily  increase. 

Let  us  erect  a  stone  to  the  memory  of  our  deceased !  Alas, 
the  number,  in  relation  to  the  period  that  has  elapsed,  is  dis- 
proportionately large  and  lamentable,  of  loyal  and  laborious 
men  who  have  been  removed  from  among  us.  In  Germany 
we  "have  to  mourn  Von  Benniger,  Degen,  Glass,  Hartz,  Carl 
Haubold,  Perutz,  Vincenz  Vrecka,  who  by  his  efforts  on 
behalf  of  his  poorer  colleagues  has  raised  his  own  monimient, 
and  Eitter  Hofrath  Schwarze ;  in  England,  Atkin  and  Homer, 
of  Hull,  and  Eogers,  of  London ;  in  France,  the  learned  Tessier ; 
in  Italy,  Treppi,  Director  of  the  Academy  of  Homoeopathy  at 
Palanno  (he  was  murdered  in  the  open  street);  in  Belgium,  Bron, 


160  Some  UnjruUished  Letters  of  Hahnemann, 

of  Brussels;  in  Switzerland,  Gsell,  of  St.  Gall;  in  Spain, 
Aloiizo  y  Pardo,  of  Madrid ;  and  in  America,  the  industrious 
provor  and  accomplished  and  much  loved  physician,  Dr  Joslin, 
of  New  York,  and  Eeichelm,  of  Philadelphia. 

And  that  we  may  not  close  with  sadness,  we  shall  turn  once 
more  from  those  who  are  gone  to  those  who  still  remain,  and 
enumerate  the  names  of  the  men  who,  to  their  own  honour  and 
to  the  honour  of  Homoeopathy,  have  received  distinctions  and 
decorations.  To  this  number  belong  Fleischmann,  of  Vienna, 
who  has  received  the  additional  order  of  the  Prussian  Crown 
(den  Preuss.  Kronorden);  Wank,  Physician  to  the  Staff,  who  has 
received  the  Archducal  Hessian  Ritter  Kreuz  of  the  first  class ; 
Gunther  of  Langensalza,  who  has  obtained  a  Prussian  Order  of 
Merit  (Verdienst-Medaille)  ;  Weber,  Physician,  to  the  Queen  of 
Hanover,  who  is  appointed  Superior  Member  of  the  Medical 
Council ;  and  Stens,  of  Bonn,  who  has  been  named  a  Member 
of  the  Sanitary  Council  of  Prussia. 

In  conclusion,  we  may  be  permitted  to  refer  to  the  fact,  that 
in  the  year  1862  this  journal  completed  the  thirtieth  yesiT  of 
its  existence.  May  it  continue  to  enjoy  the  favour  and  good 
wishes  of  its  readers  and  fellow- workers ! 


SOME  UNPUBLISHED  LETTEES  OF  HAHNEMANN. 

To  Dr.  Staff. 

KoetJien,  August  18th,  1829. 

Dear  Colleague, 

I  can  bear  much  joy  and  much  grief,  but  I  was  quite 
overcome  by  the  surprise  I  got  from  so  many  and  so  strong 
demonstrations  of  the  kindness  and  love  of  my  disciples  and 
friends,  which  overwhelmed  me,  on  the  18th  of  August.  And 
now,  as  I  come  gradually  to  myself,  and  examine  one  by  one 


Some  Unpublished  Letters  of  Ilahnrnwnn.  1  fi  I 

the  gifts  bestowed  on  me  by  so  many  kind  hearts,  I  am  more 
and  more  astonished  at  their  magnificence  and  olo<^iinco,  and 
the  amount  of  thought  and  trouble  they  must  liave  cost.  1 
have  not  deser\^ed  them:  they  are  the  fruits  of  ;;enerosity,  allV-^- 
tion,  and  exaggerated  gratitude.  I  know  how  to  vahio  their 
worth.  I  beg  that  you  will  communicate  my  feeble  expres- 
sions of  thanks  to  the  donors,  and  retain  yourself  a  ^syowt 
share. 

Now  for  business.  Along  with  this  I  send  you  a  lettor 
from  good  Dr.  Hering,  and  I  must  request  you  to  enclose  tli<^ 
accompanying  answer  when  you  write  to  him,  as  I  liare  no 
opportunity;  it  contains  some  of  the  new  anti-proric  medicines, 
— Alumina,  Causticu/ni,  Natrum  if.,  Kali,  and  Conivm. 

I  also  send  you  an  article  fi*om  our  friend  Schmit,  in  wliich, 
by  his  desire,  I  have  dropped  an  observation  liere  and  there. 
For  a  first  publication  (so  far  as  I  know,  ho  has  not  printed 
anything  yet)  it  is  done  in  excellent  style.  I  gave  him  the 
material  for  it  here,  and  compelled  him,  in  sjnte  of  his  mo- 
desty, to  put  it  together.  We  will  urge  him  to  give  some- 
thing more  to  the  world.  God  grant  it  may  go  well  with  him 
in  Lucca ! 

With  regard  to  Colonel  Bock,  at  least  he  did  me  good  service, 
for  he  went  from  here  to  Halle,  at  his  own  expense,  to  see 
Professor  Schweickert,  and  made  him  promise  to  print  my 
article,  and  send  a  copy  of  it  to  Bnmswick,  which  accordingly 
was  done,  with  a  letter  requiring  three  florins  as  the  cost  of 
the  printing,  otherwise  it  could  not  appear.  I  leave  you  to 
judge  of  this  conduct,  as  also  of  the  introduction  which  the 
Halle  gentlemen  have  thought  proper  to  put  before  my  article, 
the  expenses  of  wliich  Bock  had  also  to  pay.  They  seem  to  have 
considered  my  article  as  an  offence  wliich  required  justification 
at  their  hands,  and  save  themselves  with  diplomatic  particu^ 
larity  of  expression,  as  if  what  I  had  written  the  publisher  did 
not  wish  laid  at  his  door.     AVhat  rudeness  and  vituperation  ! 

I  send  it  to  you,  and  recjuest  its  return ;   but  I  am  afraiil 

VOL.  m.  U 


162  Some  UTvpvhlished  Letters  of  Hahnemann. 

that,  although  they  have  swallowed  the  Coloners  three  florins, 
they  will  yet  not  put  the  thing  into  the  journal,  and  tlius  tlie 
whole  design  will  be  frustrated. 

I  beg  of  you,  as  soon  as  you  see  the  article  in  the  journal, 
to  inform  me  at  once  by  post,  that  I  may  begin  the  printing 
of  the  fourth  part  of  the  Chronic  Diseases :  before  that  I  shall 
not  stir  a  step. 

Ah !  how  wearisome  and  hard  it  is,  and  how  beset  with 
obstacles,  to  bring  truth  into  the  world,  and  overcome  preju- 
dice !  If  the  good  did  not  itself  repay  the  doer  by  the  sense 
of  approval  from  above,  and  out  of  the  depths  of  his  own  con- 
science, then  good  would  remain  undone.  With  warmest  greet- 
ings to  Eumond,  Gross,  Franz,  and  Gerstorflf,  I  remain. 

Yours  most  truly, 

Samuel  Hahnemann. 

As  I  am  sending  you  a  packet,  I  enclose  the  newspaper 
which  gives  an  account  of  our  fete.  I  do  not  know  where  the 
editor  got  it :  not  one  word  did  he  get  from  me.  I  wish  the 
authorship  of  that  article  of  mine  to  be  strictly  concealed, 
otherwise  it  would  be  immediately  attacked,  and  its  contents 
would  never  be  fairly  judged. 

To  Dr.  Hering. 

Koethen,  Sept.  13th,  1833. 
My  dear,  good  Hering, 

I  wish  you  joy  of  being  in  the  land  of  freedom,  where 
unhindered  you  can  work  all  the  good  that  is  in  your  heart ; 
there  you  are  in  your  element.  To  stimulate  your  zeal  for 
our  beneficent  art  would  be  to  pour  oil  upon  fire.  You 
ratlier  require  to  be  held  back  that  you  may  not  injure  yourself 
and  reminded  of  the  care  due  to  your  health,  which  is  dear  to 
all  true  friends  of  Homoeopathy. 

When  you  get  Kopp's  book  and  the  Algem.  Horn.  Zeitimg, 
you  will  read  with  regret  with  what  revolting  impiidence  a 
mixture  of  aUopathic  impotence  with  superficial  Homoeopathy 


Some  Unpublished  Letters  of  Halinnnann.  1<'»3 

has  b^on  to  be  made»  and  placed  above  the  pure  Homoeopathy, 
which  is  clamoured  against  as  imperfect  and  insufficient  for 

the  cure  of  diseases.     In  Leipsic, ^^tis  the  hea<l 

of  that  sect,  and  almost  all  the  members  of  the  Homoeopathic 
Society  there  belonged  to  it.  Twice  in  successive  years  1  had 
warned  them  privately  in  a  paternal  and  strongly  woixled 
pastoral  letter,  but  they  continued  to  carry  on  their  monstrous 
system,  and  they  would  undoubtedly  have  polluted  the  Horac^o- 
pathic  Hospital  which  was  being  erected  with  this  horror,  if  1 
had  not  broken  a  stick  over  their  heads  in  the  Leipsic  paper. 
Then  they  called  out  that  I  wished  to  limit  their  freedom  of 
independent  action,  and  that  I  was  wrong  in  fearing  tliiit  they 
would  practise  otherwise  than  purely  homoeopathically  in  tlip 
hospital,  and  that  it  was  to  be  public,  as  a  matter  of  course. 
But  they  only  ventured  to  publish   in  various  homoeopathic 

journals  's  explanation,  that  it  was  his  plan  to 

practise  allopathically  to  a  certain  extent,  which  would  have 
been  a  scandal  to  all  the  world,  and  brought  our  science  to 
suspicion  and  reproach,  if  I  had  not  launched  my  thunderbolt 
upon  them.  A  certain  Dr.  Kutschman  advanced  to  their  de- 
fence,   whom  I  drove  home ;  then  followed and 

,  who    audaciously    maintained  that   bleeding,  leeching, 

&c.,  were  indispensable  to  cure,  according  to  their  experience. 
I  could  have  answered,  but  I  did  not  like,  that  their  deficient 
homoeopathic  knowledge  was  not  the-  standard  of  the  full 
powers  of  the  system ;  that  they  left  many  uncured  and  sent 
them  to  their  grave,  whom  a  true  homoeopatliic  treatment  would 
have  rescued.  The  whole  Leipsic  Society  threatened  me  with 
open  enmity ;  however,  I  let  them  proclaim  their  false  teaching, 
which  they  called  eclecticism,  in  the  Algem.  Horn,  Zeitunff,  and 
thus  they  drew  upon  themselves  a  public  stigma  in  the  eyes  of 
all  the  true  disciples  of  Homoeopathy.  In  the  meantime,  in 
the  5th  edition  of  the  "  Organon,"  I  have  done  full  credit  to 
this  movement.  This  scandal  caused  me,  however,  much  dis- 
tiefls. 


164  Lecture  by  Dr.  Russell 

On  the  10th  of  August  I  had  some  20  of  the  best  disciples 
with  me.  Bonninghausen  was  among  them,  and  they  all  came 
to  the  unanimous  conclusion,  that  a  true  Homoeopathist,  besides 
giving  a  simple  and  carefully  selected  medicine  for  a  disease 
ascertained  with  care,  would  also  avoid  all  palliatives  and  every- 
thing that  would  weaken  the  patient,  as  well  as  all  external 
stimulation  by  irritants.  God  help  you  in  your  good  efforts,  and 

Believe  me,  yours  truly, 

Samuel  Hahnemann. 


ON  SOME   MOEBID  AFFECTIONS  OF  THE  NEEVOUS 
SYSTEM.— BY   DR    EUSSELL. 

Lectuke  I. — Epilepsy. 
Gentlemen, 

On  looking  over  the-  tables  of  the  diseases  treated  in  this 
Hospital  during  the  last  year,  I  was  struck  with  the  small  number 
of  recoveries  entered  under  the  heading  "Diseases  of  the  Spinal 
Marrow  and  Nerves."  Out  of  27  cases  only  2  are  returned  as 
cured,  1 0  were  much  improved,  and  8  left  very  much  as  they 
entered.  The  list  includes  cases  of  hemiplegia,  hysteria,  spinal 
irritation,  cerebral  affections,  spinal  disease,  mental  derangement, 
and  partial  paralysis.  It  does  not  embrace  epilepsy,  as  epileptic 
persons  are  generally  able  to  attend  among  the  out-patients. 
If  it  had,  the  statistical  returns  might  have  been  somewhat 
improved.  As  these  at  present  stand,  we  perceive  that  the 
diseases  of  the  nervous  system  are  really  the  most  formidable 
class  we  encounter  in  our  practice,  and  unfortunately  this  class 
is  probably  greatly  on  the  increase  in  this  country,  and  in  every 
country  where  there  is  a  perpetual  struggle  for  existence  on  the 
part,  not  only  of  the  working  population — whose  firataies,  when 


an  EpUtpsy,  165 

they  give  way,  generally  suffer  from  rheumatism  or  bronchitis — 
but  also  equally  or  more  on  the  pai-t  of  the  upper  classes,  who 
live  by  their  brain  and  nervous  system,  and  wlio,  besides  tlie 
constant  strain  under  which  the  strongest  often  succumb,  are 
exposed  to  sudden  vicissitudes  of  fortune. 

I  propose  to  confine  my  obsef\'ations  in  tliis  lecture  to  tlie 
subject  of  Epilepsy. 

It  is  calculated  (Sieveking,  p.  80)  that  tliere  are  alx)ut 
56,000  epileptic  persons  in  England.  Most,  if  not  all  of  them, 
are  under  medical  care :  thus  it  happens  that  all  practitioners 
of  any  reputation  have  almost  always  one  or  more  cases  of 
this  disease  under  treatment.  Now,  when  we  consider  the 
extreme  severity  and  the  long  duration  of  the  complaint,  the 
distress  and  anxiety  it  causes  to  the  relatives  of  the  patient, 
the  obscurity  and  perplexity  of  its  pathology,  and  the  uncer- 
tainty in  regard  to  the  proper  method  of  tieating  it,  we  need 
not  be  surprised  that  it  should  be  a  favourite  subject  for  dis- 
quisition by  medical  authors,  and  its  literature  should  be  very 
extensivCj  It  would  be  out  of  place  here  to  enter  upon  an  ex- 
amination of  what  has  been  written  even  recently  by  many 
able  and  justly  celebrated  men;  but  I  shall  freely  use  the 
information  their  works  supply,  while  endeavouring  to  afford 
the  material  for  a  satisfactory  reply  to  the  questions  which  are 
pretty  sure  to  be  asked  of  us  when  an  epileptic  patient  is  pro- 
posed to  be  placed  under  our  care. 

The  first  question  which  we  are  pretty  sure  to  be  asked  is, 
"  What  are  the  chances  of  the  patient's  recovery  ? "  From  what  ? 
The  term  epilepsy  represents  a  very  complex  and  varied  series 
of  phenomena,  and  we  must,  before  giving  an  opinion,  ascertain 
the  kind  of  epilepsy  with  which  the  person  is  afflicted.  Tliere 
are  two  very  distinct  forms ;  the  one  called  in  the  language  of 
science  epilepsia  gravior,  the  other  epilepsia  mitior,  spoken  of  by 
French  and  some  English  writers  as  le  grand  and  le  petit  mal,  and 
familiarly  .described  by  one  of  the  out-patients  of  this  Hospital, 
as  *' 1m  fits  and  his  starts''     Of  the  true  epileptic  fit,  or  falling 


166  Lecture  hy  Dr,  Russell 

sickness,  there  is  no  need  to  give  a  description.  When  once 
seen  it  is  impossible  to  forget.  It  is  not  likely  to  be  mistaken 
for  anything  else,  or  anything  else  for  it.  Sometimes  there  is 
a  difficulty  in  discriminating  between  certain  forms  of  hysteri- 
cal convulsions  and  epilepsy.  I  believe,  however,  that  a  careful 
history  of  the  case  will  almost  always  enable  us  to  decide.  As 
a  general  rule  hysteria  may  be  safely  considered  as  a  peripheral 
affection  of  spinal  and  other  nerves,  while  epilepsy  is  a  central 
affection  of  those  parts  of  the  nervous  system  which  are  included 
in  the  encephalon — i.  e.,  the  brain  proper,  the  cerebellum,  and 
the  meduUa  oblongata.  It  is  very  rarely  that  we  find  the 
mind  affected  in  hysteria ;  at  the  same  time  I  have  met  with 
cases  where  there  was  temporary  aberration  of  reason,  along  with 
violent  clonic  convulsions,  attended  with  unconsciousness  and 
ending  with  sleep,  and  yet  which  were  undoubtedly  shown  by 
the  course  they  took,  and  the  previous  history  of  the  patient's 
complaints,  to  be  of  a  hysterical  kind  and  not  to  be  epilepsy. 
Some  writers  lay  much  stress  upon  the  state  of  the  pupil 
as  a  diagnostic  sign:  I  have  no  great  faith  in  this.  It  is  diffi- 
cult to  get  a  good  view  of  the  upturned  eye  of  a  person 
rolHng  on  the  ground  and  struggling  violently,  and  I  have  ob- 
served the  pupils  in  hysteria  dilate  just  as  much  as  they  are 
said  to  do  in  epilepsy.  The  attacks  of  epilepsia  mitior  present 
a  great  variety ;  sometimes  they  are  simply  what  the  term  im- 
plies— fits  of  a  kind  similar  in  their  character,  but  much  slighter 
in  degree  than  the  regular  fits,  lasting  it  may  be  for  one  or  two 
minutes ;  sometimes  they  appear  like  what  might  be  described 
as  a  transient  blush  of  the  brain  (as  it  were) :  there  is  a  momen- 
tary suspension  of  consciousness,  and  the  slightest  possible 
tremor  of  the  hands,  and  it  is  over.  But  there  is  another  form 
bearing  an  exact  resemblance  to  natural  somnambulism,  or  to 
tlie  condition  of  persons  in  that  curious  state  known  by  the 
absurd  name  of  electro-biology,  which  seems  nothing  more  than 
somnambulism  artificially  produced.  I  had  for  some  time  under 
my  care  a  patient  afflicted  with  true  epileptic  fits,  who  was. 


on  Epilepsy.  167 

besides,  subject  to  these  attacks  of  somnambulism  in  the  day- 
time. On  one  occasion  she  called  upon  me  at  the  usual  hour 
for  receiving  patients,  and  took  her  place  in  the  waiting-room. 
When  she  was  told  by  my  servant  that  I  was  disengaged,  she 
rose  and  walked  into  my  consulting  room,  sat  down,  and 
answered  questions  quite  coherently,  although  her  manner  was 
somewhat  strange  and  absent.  However,  I  had  no  idea  she  was 
unconscious  till  she  suddenly  started,  and  declared  she?  had 
dropped  a  piece  of  money :  this  she  had  ceilainly  not  done  in 
my  presence,  and  her  purse  was  in  her  hand.  It  was  a  clasp 
purse  and  shut.  On  looking  in  the  waiting-room,  the  nnjney 
was  found  on  the  floor.  Immediately  after  dropping  it  she  had 
passed  into  the  state — a  kind  of  sleep — her  actions  were  no 
longer  influenced  by  direct  volition,  but  probably  by  the  obscure 
dream-memory :  by  this  impulse  she  walked  into  my  room  and 
took  her  seat,  and  she  answered  questions  as  some  persons  do 
when  asleep.  The  condition  is  a  most  curious  and  interesting 
one,  and  well  worthy  of  attentive  consideration  by  psychologists. 
It  is  wonderful  to  find  a  person  who  is  imdoubtedly  in  a  state 
of  unconsciousness,  and  not  responsible  for  her  words  or  actions, 
returning  coherent  replies  to  the  questions  put  to  her.  Tlie 
knowledge  of  this  condition  may  throw  doubts  upon  the  legal 
and  moral  responsibility  of  women  in  some  cases  of  child  murder. 
At  all  events,  it  is  well  that  we  should  be  acquainted  with  the 
fact,  that  persons  may  move  and  talk  as  if  they  were  awake 
and  rational,  while  all  the  time  they  are  in  a  profound  uncon- 
sciousness,  and  this  suddenly  and  in  the  day-time;  and  in 
circiimstances  where  the  absence  of  their  natural  intelligen(»(3 
would  not  for  a  moment  be  suspected  by  any  one  unacquainted 
with  their  habits,  or  the  nature  of  the  malady  under  which  they 
laboured. 

On  the  frequency  and  rarity  of  these  intermediate  attacks, 
and  their  lightness  or  severity,  the  prognosis  of  any  case  of 
epilepsy  in  a  considerable  degree  depends.  It  seems  to  be  gene- 
rally admitted,  that  the  frequent   recurrence   of  these  slight 


168  Lecture  by  Dr,  Russell 

attacks  is  more  unfavourable  as  regards  the  cliances  of  recovery, 
than  the  severity  or  even  the  frequency  of  the  regular  fits. 

If  the  epileptic  patient  be  under  puberty,  and  especially  if 
of  the  female  sex,  much  is  hoped  for  from  the  change  that 
attends  the  attainment  of  that  condition.  This  is  a  popular 
belief — I  fear  it  is  a  popular  fallacy.  That  epilepsy  often 
occurs  at  that  age  for  the  first  time  is  undoubted,  and  quite 
in  accordance  with  what  we  should  expect ;  for,  according  to  the 
Latin  adage,  Coitus  brevis  epilepsia  est ;  and  sexual  excitement  of 
any  kind  produces  a  violent  perturbation  of  the  nervous  system 
and  brings  the  muscular  combinations  more  directly  under  the 
influence  of  the  motions  and  less  under  the  control  of  the 
will — thus  favouring  all  convulsive  actions.  But  any  reason, 
except  the  deceitful  one,  that  what  we  wish  that  we  believe, 
there  is  for  expecting  an  existing  epilepsy  to  be  removed  by 
the  setting  in  of  puberty,  I  never  could  see,  and  I  confess  my 
own  experience  is  dead  against  it.  On  this  point  I  find  myseK 
at  variance  with  one  of  our  very  few  systematic  writers — I 
mean  Dr.  Laurie.  In  his  well-known  and  very  popular  work, 
he  says  :  "  When  the  disease  occurs  before  the  age  of  puberty y  or 
when  purely  sympathetic  (which,  by  the  bye,  epilepsy  never  is), 
it  is  generally  curable  without  much  difficulty  by  means  of 
homoeopathic  remedies."  If  Dr.  Laurie's  conviction  of  the 
early  curability  of  those  cases  of  epilepsy  which  appear  about 
the  eighth  year,  or  from  that  to  the  tweKth,  be  derived  from 
a  sufl&ciently  large  number  of  cures,  he  would  lay  the  profession 
under  a  serious  obligation  by  publishing  the  details  of  their 
treatment,  as  in  this  matter  his  experience  is  opposed  to  con- 
current medical  testimony,  and  is  in  accordance  with  universal 
popular  belief. 

In  connexion  with  the  influence  of  the  development  of 
puberty,  we  may  glance  at  the  allied  question  of  what  is  likely 
to  be  the  effect  of  marriage  upon  a  person  affected  with  epilepsy. 
We  know  that  hysteria  is  often  cured  by  marriage,  and  that  on 
the  whole  we  are  safe  in  expressing  an  opinion,  that  the  fact  of 


on  Epilepsy.  1G9 

a  woman  being  hysterical  is  no  banier  to  her  marriage.     Can 
we  say  so  much  of  epileptics  ?     This  most  important  question 
has  been  fully  discussed  by  many  able  writers.    (See  Sicvekiiig, 
p.  140.)     It  presents  itself  in  various  aspects  to  our  attcntiun. 
First,  in  the  simply  medical  point  of  view,  thus :  whether  is  it 
safer  for  a  man  affected  witli  epilepsy  to  undergo  marriage  and 
its  consequence,  or  to  abstain  ?     That  some  cases  of  epilepsy 
have  had  their  origin  in  consequence  of  marriage  is  a  well- 
known  fact.     On  the  other  hand,  it  is  athrmed  by  many  credible 
authorities,  that  similar  results  have  followed  from  enforced 
abstinence.     A  curious  case  of  the  latter  description  once  came 
under  my  own  notice.      It  was  as  follows : — A  gentleman  of 
about  twenty-four  or  twenty-five  years  of  age  had  his  leg  dis- 
located at  the  hip-joint.     The  dislocation  was  not  reduced,  and 
the  head  of  the  femur  had  to  make  a  new  socket  for  itself  in 
the  ilium.     To  enable  it  to  do  so,  the  patient  was  obliged  to  Lie 
constantly  on  his  back ;  otherwise  he  was  in  the  enjoyment  of 
a  fair  share  of  health,  of  a  most  agreeable  disposition,  highly 
cultivated,  an  only  son,  and  of  high  worldly  expectations.     In 
this  situation  he  became  attached  and  en^xiged  to  a  lady ;  and 
the  only  hindrance  to  the  match  being  the  state  of  the  limb,  he 
impatiently  waited  the  time  when  he  should  be  able  to  stand 
and  walk,  even  with  crutches.     He  so  far  recovered  as  to  do  so. 
The   marriage-day  was    fixed,   and  the  guests    were  invited; 
among  them  one  of  the  most  influential  noblemen  in  England, 
kinsman  of  the  bride.     A  death  in  her  high  circle  of  relations 
obliged  the  postponement  of  the  ceremony  for  ten  days.     Two 
days  before  that  interval  had  elapsed  the  surgeon  in  attendance 
(along  with  myself)  on  the  case  was  sent  for  in  great  haste.    On 
arriving  at  the  house  he  found  the  gentleman  in  a  severe  true 
fit  of  epilepsy,  in  which  he  expired.     There  was  no  post  Tnortcm 
examination,  but  I  had  no  reason  to  suspect  any  other  cause  of 
death.      There  was  no  previous  indication  of  any  affection  of 
the  heart.     The  particulars  of  the  last  fatal  struggle  were  fully 
detailed  to  me  at  the  time  by  the  surgeon,  who  enjoys  a  high 
reputation,. and  who  gave  it  me  as  his  opinion  that  the  death 


170  Lecture  by  Dr,  Russell 

was  owing  to  an  epileptic  seizure,  brought  on  by  the  prospect 
of  his  approaching  marriage,  and  the  excitement  and  restraint 
of  his  sexual  desires.  As  a  youth  he  had  been  of  a  very 
amorous  disposition,  and  his  accident  had  prevented  him  from 
indulging  it. 

Admitting  the  facts  of  this  case  and  the  inference,  they 
may  be  interpreted  either  for  or  against  the  prudence  of 
matrimony  in  the  circumstances.  It  is  quite  possible  that, 
had  this  gentleman  married  on  the  day  he  first  intended,  he 
might  have  escaped  his  melancholy  fate.  At  the  same  time,  it 
is  quite  possible  that  the  latent  epileptic  forces  which  slum- 
bered in  his  brain  might  have  been  called  out  into  equally  fatal 
energy  by  the  consummation  of  the  marriage  act,  and  have 
made  his  end  even  more  tragical  Thus,  we  are  compelled  to 
leave  the  question  as  to  the  propriety  of  the  marriage  of  an 
epileptic  person  for  the  decision  of  the  parties  chiefly  interested. 
All  we  can  say  is — it  may  do  good,  and  it  may  do  harm,  and 
it  may  do  neither  good  nor  harm.  But,  beyond  this,  if  we 
enter  upon  the  general  expediency  of  the  step,  we  have  no 
difficulty  in  coming  to  a  conclusion  against  it,  especially  if  the 
epileptic  be  a  woman.  On  this  point,  we  have  a  clear  voice  of 
warning,  furnished  by  statistics;  for  we  find  that  out  of  110 
epileptic  persons  there  were  31,  or  nearly  one-third,  who  had 
epileptic  parents,  or  near  relatives,  and  (what  is  still  more  con- 
clusive) 14  epileptic  women  gave  birth  to  58  children.  Of 
these  58  so  born,  37  had  died  under  14  years  of  age,  and 
almost  every  one  of  these  37  had  died  of  some  convulsive 
disease.  With  such  facts  before  us,  it  may  be  our  duty  to 
warn  any  epileptic  who  asks  our  advice  on  the  question  of 
marriage,  of  the  dreadful  consequences  he  is  likely  to  entail 
upon  his  offspring — if  the  marriage  be  fruitful.  If,  however, 
from  the  age  of  the  parties,  or  any  other  cause,  there  is  no 
chance  of  offspring,  this  would  materially  modify  our  opinion 
as  to  the  expediency  of  the^'step.  When  we  are  asked  to  give 
our  opinion  as  to  the  probable  course  and  termination  of  a  case 
of  epilepsy,  it  is  likely  that  we  shall  be  pressed  to  say  whether 


on  Epilepsy,  171 

there  is  great  danger  of  its  destroying  the  mind,  and,  un  this 
point,  we  should  be  well  prepared  to  give  exact  information. 
The  prevailing  belief,  both  popular  and  professional,  is,  that 
epilepsy  is  very  apt  to  end  in  idiocy,  or  some  other  form  of 
insanity.  Now,  there  is  no  doubt  of  the  close  connexion  of  the 
two  conditions;  but  Dr.  Badcliffe  ver}"  pertinently  observes 
that  epilepsy  as  often  begins  as  ends  in  madness, — that  is,  the 
condition  of  the  brain  which  induces  the  latter  condition  favours 
the  development  of  the  former,  and  thus  we  are  apt  to  be 
misled  and  to  take  too  unfavourable  a  view  of  the  prospects  of 
an  epileptic  patient.  The  fact  is,  that  the  subjects  of  epilepsy 
fell  into  the  hands  of  what  are  popularly  called  the  mad- 
doctors.  They  found  their  epileptic  patients  going  on  from  bad 
to  worse  till  they  became  perfect  idiots,  and  this  they  ascribed 
to  the  epileptic  attacks,  whereas  the  chances  are  that  the  fits  of 
these  poor  creatures  were  owing  to  the  causes  of  their  fatuity. 
A  more  careful  study  of  the  matter  has  led  to  a  different 
conclusion,  and  the  result  is,  that  we  have  one  of  the  most 
recent  writers  on  Epilepsy  giving  as  the  result  of  his  induction, 
that  "  the  duration  of  epilepsy  is  per  se  without  influence  upon 
the  mental  condition  of  the  epileptic."  (Russell  Reynolds, 
p.  173.)  So  far  as  my  own  experience  goes,  it  entirely  con- 
firms this  opinion.  I  have  had  the  opportunity  of  observing  a 
considerable  number  of  epileptics,  as  I  happened  to  have  had 
one  or  two  veiy  striking  recoveries  in  my  practice  a  good  many 
years  ago,  and,  in  consequence,  there  was  quite  a  msh  of  this 
class  of  patients.  At  that  time,  I  had  the  impression  that  there 
was  a  progressive  deteriomtion  of  the  powera  of  the  mind  as  a 
rule ;  tut  I  have  not  found  it  so.  I  have  watched  a  good  many 
of  these  'patients,  and,  I  am  sorry  to  say,  I  have  not,  in  many 
of  them,  seen  improvement.  Still,  although  the  fits  have  been 
as'  frequent  and  as  severe  as  they  ever  were,  yet  the  mind,  if  it 
has  not  developed,  has  not  retrograded.  However,  I  have 
seldom  observed  the  natural  development  to  go  on.  Epilepsy 
seems  to  blight  its  powers  of  growth,  to  arrest  the  mind  in  the 


172  Lecture  by  Dr.  Russell 

state  it  was  in,  hut  frequently  to  do  no  more.  Out  of  64  cases 
of  t7^e  epilepsy  observed  by  Dr.  Eeynolds,  in  24,  or  above  38 
per  cent.,  the  intellect  was  wholly  unimpaired ;  in  20,  or  above 
32  per  cent.,  there  was  only  slightly  impaired  memory  for 
recent  events ;  in  9,  or  about  1 5  per  cent.,  the  apprehension, 
as  well  as  the  memory,  was  impaired ;  and  in  9  there  were 
general  confusion  of  ideas,  amounting  to  imbecility.  If  the 
whole  number — 64 — be  too  small  to  permit  us  to  accept  of 
the  propositions  exhibited  by  these  figures  as  altogether  trust- 
worthy, they  are  large  enough  to  prevent  our  accepting  the 
general  notion  that  epilepsy,  if  imchecked,  passes,  as  a  rule,  into 
mental  imbecility.  In  quoting  the  tables,  I  emphasized  the 
true  prefixed  to  the  word  epilepsy ;  for,  probably,  one  main 
cause  of  what  seems  to  have  been  an  erroneous  impression  in 
regard  to  the  effect  of  epilepsy  upon  the  mind  was  confoimding 
this  disease  with  cases  of  epileptiform  affections  depending 
upon  tumours  of  the  brain — in  which  disease,  along  with  the 
most  dreadful  convulsions,  we  have  utter  prostration  of  the 
mental  powers. 

Another  favourite  fallacy  is,  that  much  may  be  done  by 
attending  to  the  general  health.  Now,  this  requires  special 
attention,  if  there  be  any  such  derangement  of  the  health  as 
is  or  may  be  an  exciting  cause  of  the  paroxysms — e,  g. 
intestinal  worms — then  we  may  reasonably  hope  that,  with 
their  removal,  there  will  be  a  cessation  of  the  fits.  But  even 
here,  we  must  not  be  too  sanguine.  We  must  remember  that 
"  fits,"  entirely  caused  by  worms  or  by  teething,  are  not 
epilepsy ;  that  they  are  merely  peripheral  irritation,  exciting  an 
action  on  a  comparatively  healthy  central  nervous  system ; 
which  action  subsides  when  this  irritation  ceases.  But  in- 
testinal worms  may  be  present  in  a  person  predisposed  to 
epilepsy,  and  be  the  exciting  cause  of  the  first  attack.  If  this 
be  the  case,  we  have  no  reason  to  expect  to  effect  a  cure  of  the 
epilepsy  by  merely  removing  the  wormsf.  Any  excitement  may 
rouse  the  latent  epileptic  condition  into  active  manifestation. 


on  Epilepsy.  17»^ 

For   example :   "  I  have   seen,"    says  Van   Swieten,  *'  a    very 
healthy  girl  of  ten  years  of  age,  bom  of  sound  parents,  who 
never  had  epilepsy,  rendered  epileptic  for  several  years,  and  tlie 
first  time  she  was  seized  was  upon  having  her  soles  tickled  by 
some  girls  who  were  at  play  with  her,  some  of  them  holding 
her  fast  upon  the  floor  to  prevent  her  avoiding  the  intolerable 
sensation.'*     Now,  as  school-girls  have  tickled  school-girls,  and 
school-boys    school-boys,  from  time  immemorial,   and  this  is 
the  only  case  on  record  of  such  tickling  having  given  rise    to 
epilepsy,  we  may  unhesitatingly  conclude  that  although,  in  one 
sense,  the  tickling  caused  the  epilepsy,  yet  it  would  not  have 
done  so  had  not  all  the  materials  for    explosion  been  ready 
to  ignite  upon  the  application  to  them  of  ani/  spark  ;  and  that, 
if  instead  of  being  tickled  this  girl  had  eaten  too  many  raw  apples, 
or  any  other  indigestible  food,  or  if  worms  had  been  generated 
in  her  intestines,  she  would  equally  have  had  her  epilepsy. 
It  is  too  late  now  to  attempt  to  comfort  her  companions,  who, 
from  the  way  the  case  is  told,  must  have  gone  down  to  their 
graves  a  century  ago,  with  this  sin  upon  their  conscience ;  but 
it  is  not  too  late  to  point  out  the  absurdity  of  promoting  a 
mere  accidental   exciting  cause  into   a  primary  agent  in  the 
production    of  this    disease.     And  if  we,   on  finding  that   a 
paroxysm   of  epilepsy  was  first  caused  in  any  given  case  by 
worms,  at  once  jump  at  the  conclusion  that  all  we  have  to  do 
is  to  remove  the  worms,  we  shall  commit  a  grave  error,  and 
may  give  rise  to  unwarrantable   hopes   and  bitter  disappoint- 
ment. While,  on  the  one  hand,  we  cannot  always  give  security 
against  the  recurrence  of  the  fits  of  epilepsy,  by  removing  the 
exciting  cause  which  originally  induced  the  paroxysms — as,  for 
example,  irritation  of  the  gums  from  teething— on  the  other 
hand,  the  attacks  of  the   disease  may  be  held  in  abeyance  for 
an  indefinite  length  of  time  by  arresting  the  propagation  of  the 
irritation  from  the  circumference  to  the  centre.     Dr.  Brown- 
S^uard,  in  his  treatise  on  Epilepsy,  quotes  from  Odier  a  strik- 
ing case  in  point.     A  man  had  frequent  cramps  in  the  little 


1 74  Lecture  hy  Dr,  Russell 

finger  of  his  left  hand.    The  contractions  went  on  increasing  in 
extent  and  frequency ;  they  by  degrees  extended  to  the  fore- 
arm, the  arm  and  the  shoulder,  always  beginning  in  the  little 
finger.     At  last  they  arrived  at  the  head,  and  then  true  fits  of 
epilepsy,  with  loss  of  consciousness,  took  place.     By  means  of 
two  peculiar  ligatures  round  the  arm  and  the  fore-arm,  and 
which  the  man  could  tie  easily,  when  ie  felt  contraction  of 
the  little  finger,  the  attacks  were  prevented  at  every  threaten- 
ing for  two  or  three  years.     Unfortunately,  one  day,  he  ate 
and  drank  too  much,  and  being  intoxicated  he  forgot  the  liga- 
ture,  when  the  initial   cramp  appeared,  and  then  he  had  a 
violent  fit.     From  this  time  the  ligature  had  no  more  influence 
over  the  fits ;  they  became  very  frequent,  and  always  began  in 
the  little  finger.     Paralysis  came  on,  and  the  patient  died  in 
coma.     On  examining  the  head  of  this  patient,  an  enormous 
tumour  was  found  in  the  left  side  of  the  brain,  below  a  place 
where  the  cranium  had  been  wounded   long  before.     "This 
case,"  adds  Dr.  Brown-S^quard,  "  and  the  facts  observed  in  my 
animals,"   (i.  e.  the  animals  on  which  he  had    experimented,) 
"  positively  show  that  the  apparent  outside  origin  of  epileptic 
fits,  does  not  prove  that  there  is  not  an  organic  cause  in  the 
nervous  centres."     A  somewhat  similar  case  is  related  by  Dr. 
Eeynolds,  who  once  witnessed  and  himself  arrested  the  invasion 
of  the  epileptic  force.     "  The  attacks,"  he  writes,  "  are  always 
preceded  by  a  stabbing  pain  in  the  lower  part  of  the  belly  of 
the  left  biceps  muscle,  on  the  inner  side  especially.     The  pain 
is  not  in  the  skin,  but  deeper,  and  seems  to  go  through  the 
arm.     If  this  joint  is  immediately  grasped,  so  as  to  press  both 
skin  and  muscle  against  the  bone,  the  pain  ceases  in  a  few 
seconds,  and  nothing  more  occurs.     If  pressure  is  not  exerted 
directly,  the  biceps  contracts  and  draws  up  the  fore-aim,  and 
it  requires  firmer  grasping  and  drawing  up  of  the  fore-arm  to 
prevent  the   attack.     The  pressure  must  be  exerted  on  the 
biceps ;  the  effect  is  not  produced  by    directing  it  upon  the 
trunks  of  the  nerves,   or  upon  the  blood-vessels.     Once,  while 


oti  Ejnhpny,  17"» 

a  fit  was  arrested  with  my  own  hand,  I  ohservod  both  radial 
and  ulnar  arteries  to  be  still  pulsating.  There  in  no  doubt 
about  the  fact  that  this  pressure  does,  in  some  way  or  otlicr, 
arrest  the  attacks;  it  effects  more  than  a  relief  of  pain,  which 
might  or  might  not  run  on  into  a  paroxysm.  This  I  had  occa- 
sion to  establish  once  by  an  attack  coming  on  while  I  was 
talking  to  the  patient.  He  said,  '  Here  it  comes/  and  Ids  face 
betrayed  great  horror ;  his  respiration  ceased,  and  his  pupils 
dilated  widely.  I  grasped  the  arm  firmly,  and  the  natund 
expression  of  face  returned,  the  pupils  contracted,  the  face 
flushed,  perspiration  broke  out,  and  nothing  more  occurred. 
He  did  not  lose  his  consciousness.  The  fits  when,  as  he  ex- 
presses it,  'they  get  past  the  arm,'  are  fully  developed  jm- 
roxysmjs  of  epilepsia  gravior."     (Op.  cit.,  p.  94.) 

These  two  very  instructive  cases  demonstrate  the  possibility 
of  keeping  even  the  worst  class  of  cases  of  epilepsy  in  a  state 
of  abeyance,  if  we  can  discover  what  gives  the  initiative  to  the 
paroxysm,  and  cut  this  off,  so  that  it  does  not  get  into  the  inte- 
rior, as  it  were.  We  gather  too,  from  these  histories,  the  lesson 
of  the  necessity  of  a  very  careful  investigation  of  all  the  steps 
of  the  process  of  the  complex  series  of  phenonena  called  "a  fit;" 
and  if  we  see  our  way,  either  by  mechanical  contrivances  or  by 
medicine,  to  get  hold  of  the  first  link  in  the  chain,  then  we 
become  masters  of  the  situation,  and  may,  without  imprudence, 
hold  out  a  fair  hope  of  averting  the  dreadful  consequences  that 
follow,  if  the  evil  is  not  arrested  at  its  origin. 

I  had  lately  under  my  charge  a  patient  suffering  under 
epilepsia  gravior,  the  first  symptom  in  whose  case  was  a  fulness 
of  the  veins  of  the  back  of  the  neck.  I  never  had  myself  an 
opportunity  of  observing  this,  but  it  was  described  to  me  by  the 
mother  of  the  patient,  a  person  of  education  and  intelligence, 
and  she  informed  me  that  the  only  treatment  that  had  done  her 
daughter  any  good,  during  the  sixteen  years  under  which  she 
had  suflFered  from  the  disease,  was  a  course  of  medical  rubbing 
by  Mr.  Beveridge,  of  Edinburgh.     In  this  case  we  may  presume 


176  Lecture  by  Dr,  R%issell 

that  the  exciting  cause  of  the  attack  was  venous  congestion  of 
the  brain.    We  know  from  the  experiments  of  Sir  Astley  Cooper, 
that  interfering  with  the  proper  circulation  within  the  head 
will  produce  convulsions.     These  experiments  are  so  important, 
that  it  may  be  as  well  to  advert  more  fully  to  them.     He  states 
that,  having  tied  the  carotid  arteries  of  a  rabbit,  respiration 
was  somewhat  quickened,  and  the  heart's  action  increased,  but 
no  other  effect  produced.     In  five  minutes  the  vertebral  arteries 
were  compressed  with  the  thumb,  the  trachea  being  completely 
excluded.      Respiration    almost    directly    stopped,    convulsive 
struggles  succeeded,  the  animal  lost  consciousness,  and  appeared 
dead ;  the  pressure  was  removed,  and  it  recovered  with  a  con- 
vulsive inspiration.     It  lay  upon  its  side,  making  violent  convul- 
sive efforts,  breathed  laboriously,  and  its  heart  beat  rapidly ;  in 
two  hours  it  had  recovered,  but  its  inspiration  was  laborious. 
The  vertebrals  were  compressed  a  second  time,  respiration  stopped, 
then  succeeded  convulsive  struggles,  loss  of  motion,  and  apparent 
death  :  when  let  loose  its  natural  functions  returned  with  a  loud 
inspiration,  and  with  breathing  excessively  laboured.     In  four 
hours  it  was  moving  about  and  ate  some  greens.     In  five  hours 
the  vertebral  arteries  were  compressed  a  third  time,  and  with  the 
same  effect, — in  seven  hours  it  was  cleaning  its  face  with  its 
paws.      In  nine  hours  the  vertebral  arteries  were  compressed  for 
the  fourth  time,  and  with  the  same  effect  upon  the  respiration ; 
after  thirteen  hours  it  was  lively.     In  twenty-four  hours  the 
vertebrals  were  compressed  for  the  fifth  time,  with  the  same 
result,  viz. :  suspended  respiration,  convulsions,  loss  of  motion, 
and  unconsciousness.     After  forty-eight  hours,  for  the  sixth 
time,  the  same  results   were   obtained  by  pressure.     Thus  it 
appears,  if  the  carotids  are  tied,  that  simple  compression  of  the 
vertebrals  puts  an  entire  stop  to  the  functions  of  the  brain. 
The  experiment  was  reversed,  the  vertebrals  tied,  and  the  carotids 
compressed,  with  similar  results.     Tieing  the  vertebrals  caused 
the  breathing  to  become  laborious,  the  animal's  right  ear  fell, 
and  the  right  fore-leg  was  partially  paralysed ;  in  five  hours  it 


OH  EpilejWf.  177 

ran  about.  The  following  day,  when  the  carotids  were  com- 
pressed, it  fell  on  its  side,  losing  all  sensation  and  volition,  and 
recovered  on  withdrawal  of  pressure.  Tlie  same  results  were 
repeatedly  obtained.  When  both  vertebral  and  carotid  aiteries 
were  tied  at  the  same  tiinc,  the  animal  breatlicd  no  more  ;  but 
there  were  thirteen  to  fourteen  con\Tilsive  contractions  of  tlie 
diaphragm,  and  convulsions  of  the  hinder  extremities,  and  tlic 
animal  ceased  to  exist.  (Guy's  Hospital  Reports,  vol.  i.  p.  457. 
Sieveking,  op.  cit.,  p.  196.) 

Although  these  experiments  by  no  means  prove  tliat  venous 
cerebral  congestion,  or  a  defective  supply  of  arterial  blood,  is  the 
cause  of  epilepsy,  yet  they  establish,  beyond  a  doubt,  that  such 
a  condition  of  the  brain  excites  convulsions  ;  and  if  the  person 
in  whom  this  congestion  takes  place  be  of  an  epileptic  habit,  then 
there  can  be  no  question  that  in  sucli  a  person  it  will  give  rise 
to  true   epileptic  paroxysms,  and  that,  upon  the  relief  of  the 
congestion,  the  immunity  from  attacks  will  in  a  great  measure 
depend.     In  giving  an  opinion  as  to  the  danger  to  life,  our  at- 
tention should  be  directed  to  the  state  of  the  tongue — if  this 
presents  marks  of  having  been  bitten,  it  is  affirmed  by  Schroder 
van  der  Kolk  that  there  is  less  risk  of  a  fatal  termination  of 
the  disease.     Tlie  reason  he  assigns  is  this.     The  most  danger 
to  life  is  from  violent  irritation  of  the  par  vagimi.     Now  he 
found  that  in  patients  who  had  habitually  bitten  their  tongue, 
the  capillary  vessels  in  the  course  of  the  hypoglossal  nucleus 
in  the  medulla  oblongata  were  of  a  greater  i^roportional  size  as 
compared  with  those  in  the  track  of  the  par  vagum,  than  in 
epileptic  patients  who  had  been  in  the  habit  of  biting  their 
tongue.     The  opinions  of  this  celebrated  anatomist  upon  this 
point,  which  seem  to  have  been  suggested  by  his  observations 
on  the  morbid  structure,  have  received  confirmation  from  the  ex- 
perience of  practical  observers,  and  we  may  accept  them  as  so  far 
established,  and  assign  to  the  presence  or  absence  of  this  symp- 
tom a  place  among  the  facts  on  which  we  form  a  judgment  of 
the  probability  of  a  sudden  fatal  termination  of  any  given  case. 
YOU  m.  12 


178  Lecture  by  Dr.  Russell 

It  may  be  well  here  to  enter  somewhat  more  fully  into  the 
pathology  of  epilepsy,  as  undoubtedly  the  subject  has  been 
more  successfully  investigated  in  recent  times ;  and  if  we  have 
not  arrived  at  a  solution  of  all  the  difficulties,  we  have  at  all 
events  received  some  useful  hints  for  the  direction  of  our  cura- 
tive efforts. 

Dr.  Schroder  van  der  Kolk  regards  the  medulla  oblongata  as 
the  centre  of  general  reflex  actions,  and,  of  course,  as  the  starting 
point  of  epileptic  and  other  convulsive  diseases.  He  considers 
that,  however  remote  the  seat  of  the  primary  irritation  may  be, 
that  in  the  medulla  oblongata  is  the  mine  which  is  always  fired 
wherever  the  train  be  led  from.  Hence,  he  has  directed  his 
special  attention  to  the  investigation  of  the  minute  morbid 
anatomy  of  this  portion  of  the  nervous  system.  The  general 
results  of  his  observations  are,  that  in  all  dissections  of  the 
medulla  oblongata  in  epileptics,  whether  or  not  death  took 
place  during  a  fit,  he  met  with  great  redness  and  vascular 
tension  in  the  fourth  ventricle  penetrating  into  the  medulla 
oblongata,  sometimes  to  a  considerable  depth.  Transverse 
sections  through  the  whole  medulla  oblongata,  from  beneath 
the  jpons  varolii  to  the  inferior  extremity  of  the  corpora  olivaria, 
exhibited  the  part  in  the  vicinity  of  the  fourth  ventricle  of  a 
much  darker  colour,  usually  containing  some  more  distended 
vessels,  which  then  ran  either  in  the  course  of  the  roots  of  the 
hypoglossus  into  the  corpora  olivaria,  or  in  the  course  of  the 
vagus,  and  accessory  or  in  both.  Where  the  degree  of  redness 
was  slighter,  it  was  commonly  confined  to  the  posterior  half  of 
the  medulla ;  in  most  cases,  however,  this  hypersemia  extended 
into  the  corpora  olivaria,  which  were  often  furnished  with 
large  blood-vessels.  Thus,  also  in  the  raph^,  dilated  blood- 
vessels were  almost  always  visible.  After  Schroder  van  der 
Kolk  had  discovered  the  close  connexion  between  the  corpora 
olivaria  and  the  hypoglossus  nucleus,  he  found  dilated  blood- 
vessels exactly  in  this  course  in  the  first  epileptic  patient^ 
whose  brain  he  subjected  to  a  microscopic  examination.     On 


on  Epilepsy.  179 

measuring  the  width  of  the  vessels  under  the  microscope,  the 
widest  vessels  in  the  course  of  the  hypoglossiis  were  found  to 
amount  to  0.230^**  (two  hundred  and  thii-ty  tliousundth)  part 
of  a  miUem^tre ;  in  the  corpus  olivare,  to  0.305  niillcmetre  ; 
in  the  vagus,  to  0.152  millom6tre.  lie  connected  tliis  pre})on- 
derance  of  the  diameter  of  the  capillaries  in  the  course  of  the 
hypoglossus  over  that  of  the  vessels  in  the  track  of  the  vagus, 
with  the  fact  that  the  patient  had  invariably  bitten  his  ton^^ue 
in  the  fits.  On  the  other  hand,  he  discovered  that  in  a  patient 
who  had  never  bitten  his  tongue,  but  in  whom  the  respiration 
was  generally  disturbed,  the  vessels  in  the  course  of  the  vagus 
were  much  larger  than  those  in  the  course  of  the  hypoglossus- 
Hence,  the  inference  we  have  just  noticed,  that  inasmuch  as 
the  functions  presided  over  by  the  vagus  are  of  more  import- 
ance to  life  than  those  under  the  direction  of  the  hyi)oglossus, 
so  there  is  the  greater  risk  in  propoiiion  as  the  former,  and 
lesser  risk  in  proportion  as  the  latter,  are  those  chiefly  affected 
in  any  given  case  of  epilepsy.  However,  it  by  no  means  fol- 
lows, as  an  absolute  rule,  that  in  cases  in  which  the  h^^^oglossus 
is  much  affected,  the  vagus  is  comparatively  little  so;  they  may 
both  be  equally  largely  diseased,  and  in  such  a  case,  of  course, 
the  biting  of  the  tongue  would  give  no  security ;  the  respiration 
would  stiU  be  in  as  much  danger  of  being  seriously  affected, 
and  compromising  the  life  of  the  patient. 

The  extreme  difference  between  the  diameter  of  the  blood- 
vessels of  the  hypoglossus  in  a  healthy  subject,  and  an  epi- 
leptic, is  as  0.306  to  0.096,  i.  e.  as  the  306*-^  part  of  a  thou- 
sandth of  a  millemfetre  to  the  96*^  part  of  a  thousand ;  in  the 
vagus,  as  the  0.237  is  to  0.111.  Upon  such  infinitesimal  dif- 
ferences depend  health  with  all  its  enjoyments,  and  epilepsy 
with  all  its  privations  and  miseries !  If  this  slight  dilatation  of 
the  capillary  vessels  were  in  a  part  exposed  to  view, — the  eye, 
for  example, — how  easily  would  they  be  controlled  by  applying 
to  the  part  some  remedial  agent,  whose  specific  operation  took 
.effect  upon  these  vessels.  Could  we  succeed  in  discovering 
Bome  substance,  whose  action  upon  the  vessels  of  the  medulla 

1?-* 


180 


Lectwre  by  Dr.  Russell 


oblongata  is  equally  determinate,  we  might  then  indulge  the 
hope  of  curing  epilepsy,  as  we  do  iritis. 

Before  entering  upon  the  consideration  of  how  we  are  to  do 
so,  and  what  substances  hold  out  the  best  prospect  of  being 
useful,  it  will  be  well  to  give  the  analysis  of  the  pathological 
changes  in  a  fit  of  epilepsy,  as  these  have  been  suggested  by  Dr. 
Brown-Sdquard.  These  he  has  arranged  in  such  a  way  as  to 
give  a  tabular  view  of  what  he  considers  to  be  the  causes  of 
the  various  phenomena  observed  in  a  paroxysm  of  epilepsy. 


1.  Excitation  of  certain  parts 
of  the  excito-motory  side  of 
the  nervous  system,  i.  e.,  any 
irritation  by  tickling,  worms, 
&c. 

2.  Contraction  of  the  blood- 
vessels of  the  face. 

3.  Contraction  of  the  blood- 
vessels of  the  brain  proper. 


4.  Extension  of  the  excitation 
of  the  excito-motory  side 
of  the  nervous  system. 

5.  Tonic  contraction  of  the 
laryngeal  and  of  the  expi- 
ratory muscles. 

6.  Farther  extension  of  the 
excitation  of  the  excito- 
motory  side  of  the  nervous 
system. 

7.  Loss  of  consciousness  and 
tonic  contractionof  thetrunk 
and  limbs. 

8.  Laryngismus  trachaeismus, 
and  the  fixed  state  of  ex- 
piration of  the  chest. 


1.  The  effect  of  this  is  con- 
traction of  the  blood-vessels 
of  the  brain  proper,  and  of 
the  face,  and  tonic  spasm  of 
some  of  the  muscles  of  the 
eye  and  face. 

2.  Paleness  of  the  fiace. 

3.  Loss  of  consciousness  and 
accumulation  of  blood  in 
the  base  of  the  encephalon 
and  in  the  spinal  cord. 

4.  Tonic  contraction  of  the 
laryngeal,  the  cervical  and 
the  expiratory  muscles. 
Laryngismus    trachseismus. 

5.  Cry. 


6.  Tonic  contraction  extending 
to  most  of  the  muscles  of 
the  trunk  and  limbs. 

7.  FalL 


8.  InauflGicient  oxygenation  of 
the  blood,  and  general  ob- 
atadd  to  the  mtraaoe  of 


on  EpUepty, 


181 


9.  Insufficient  oxygenation  of 
the  blood,  and  many  causes 
of  the  little  oxygen  absorbed, 
and  detention  of  the  venous 
blood  in  the  nervous  centres. 

10.  Asphyxia,  and  perhaps  a 
mechanical  excitation  of  the 
base  of  the  encephalon. 


venous  blood  into  the  chest, 
and  special  obstacle  to  the 
return  from  the  head  and 
spinal  canaL 
Asphyxia. 


10.  Clonic  convulsions  every- 
where; of  the  bladder,  of 
the  uterus,  erection,  ejacu- 
lation, increase  of  many  se- 
cretions, efforts  at  inspira- 
tion. 
Cessation  of  the  fit,  coma 


11 


or  fatigue,  headache,  sleep. 


11.  Exhaustion  of  nervous 
power  generally,  and  of  re- 
flex excitability  particularly, 
except  for  respiration.  Ee- 
tum  of  regular  inspirations 
and  expirations. 

It  may  be  well  after  this  very  ingenious  analysis  of  an 
epUeptic  seizure,  as  explained  by  Dr.  Brown-S^quard,  to  con- 
sider how  the  same  phenomena  are  explained  by  Professor 
Schroder  van  der  Kolk.  "  I  think,"  he  says,  "we  have  suflacient 
reason  to  conclude  that  the  first  cause  of  epilepsy  consists  in 
an  exalted  sensibility  and  excitability  of  the  medulla  oblongata, 
rendering  the  latter  liable  to  discharge  itself,  on  the  application 
of  several  irritants,  which  excite  it  in  involuntary  reflex  move- 
ments. The  irritation  may  either  be  external  (irritation  of  the 
trigeminus),  an  irritated  condition  of  the  brain,  or,  as  is  still 
more  frequent,  it  may  proceed  from  irritants  in  the  intestines. 
Acidity,  a  torpid  state  of  the  bowels,  &c.,  are  among  the 
most  common  causes ;  in  adults  there  may  be  irritation  of  the 
intestines,  particularly  of  the  mucous  membranes,  constipation 
and  enlaigement  of  the  colon  connected  therewith ;  but  above 
all  onanism,  which  acts  so  very  much  on  the  medulla  oblongata, 
and  moat  be  r^arded  as  a  very  frequent  cause  of  epilepsy. 


182  Lecture  by  Dr.  Russell  on  Epilepsy, 

Amenorrhoea,  chlorosis,  plethora  of  the  uterus,  hysteria,  &c.,  are 
also  to  be  enumerated. 

"  In  the  commencement,  there  is  stiU  only  exalted  sensibility. 
If  this  can  be  removed  or  moderated,  the  epilepsy  gives  way 
of  itself,  especially  if  the  sensibility  (i.  e.,  over-sensitiveness)  is 
not  renewed  by  remote  causes.  But  if  the  disease  has  already 
lasted  long,  organic  vascular  dilatation  (as  before  described) 
takes  place  in  the  meduUa  oblongata,  the  consequence  of  this 
being  that  too  great  a  supply  of  blood  is  detained  there,  and  the 
ganglionic  groups  are  too  strongly  irritated,  too  quickly  over- 
charged. Every  attack  then  becomes  a  renewed  cause  of  a 
subsequent  attack,  as  the  vascular  dilatation  is  promoted  afresh 
by  every  fit.  Lastly,  increased  exudation  of  albumen  ensues 
from  the  now  constantly  distended  vessels,  whose  walls  at  the 
same  time  become  thickened,  producing  increased  hardness 
of  the  medulla,  subsequently  passing  into  fatty  degeneration 
and  softening,  thus  rendering  the  patient  incurable." 

Although,  as  we  perceive,  these  two  eminent  pathologists  do 
not  entirely  agree  as  to  all  the  causes  of  epilepsy,  yet  there  is  a 
considerable  correspondence  in  their  views  as  to  the  different 
steps  of  the  process  which  constitute  a  paroxysm ;  and  we  may 
fairly  assume  that,  if  we  have  not  arrived  at  the  whole  truth, 
we  are  at  all  events  approaching  the  solution  of  what  has 
been  long  regarded  as  one  of  the  most  inscrutable  maladies 
which  afflict  our  race,  called  of  old  the  morhus  sacer,  as  being 
a  direct  manifestation  of  demoniac  power,  and  requiring  nothing 
short  of  miraculous  intervention  to  deliver  its  miserable  sub- 
ject from  the  mysterious  and  malignant  influence  which  held 
it  in  possession.  Now  that  the  mystery  is  so  far  solved,  we 
may  hope  that  more  enlightened  therapeutics  may  enable  us 
to  achieve  greater  triumphs  over  this  terrible  malady ;  but  I 
must  reserve  for  my  next  lecture  a  consideration  of  this  part 
of  the  subject. 


183 

CASES  TREATED  WITH  HIGH  DILUTIONS. 
By  S.  Teldham,  Esq.,  Surgeon  to  the  Hospital 
The  question  of  the  positive  and  comparative  efficacy  of  the 
high  dilutions  of  medicines  has  for  some  time  occupied  a  good 
deal  of  the  attention  of  liomoeopatliic  practitionei-s.  Any- 
thing tending,  in  however  slight  a  degree,  to  the  solution  of 
this  question,  cannot  fail  to  interest  the  profession.  Clearly,  it 
can  only  be  solved  by  the  careful  obsen^ation  and  publication  of 
clinical  facts ;  and  it  is  manifest,  for  reasons  which  need  not 
be  particularised,  that  no  place  is  so  well  calculated  for  eliciting 
those  facts  as  the  wards  of  a  hospital.  Actuig  under  this  con- 
viction, the  writer  has  commenced  a  course  of  exijeriments  with 
the  patients  under  his  care  in  the  Hospital.  The  plan  adoptedi 
thus  far,  has  been  to  conmience  with  the  200th  dilution,  and  to 
continue  it  as  long  as  the  welfare  of  the  patients  seems  to 
justify  such  a  course — i.  e.  until  that  dilution  has  had  a  fair 
trial,  and  has  failed  in  producing  the  expected  results.  The 
200th  dilution  has  been  selected  as  being  a  fair  medium  stage 
in  the  scale  of  high  dilutions,  and  because  it  would  seem  to  be 
the  one  much  relied  on  by  those  who  use  the  high  potencies. 

The  writer  is  anxious,  in  this  matter,  to  hold  the  place  of  an 
impartial  inquirer ;  and,  in  order  that  he  may  not  influence  tlie 
opinions  of  others,  he  purposely  withholds  his  own  impressions 
and  restricts  himself,  for  the  present,  simply  to  a  detail  of  the 
cases  as  they  are  recorded  by  the  house  surgeon. 

The  first  batch  of  cases  is  now  presented  to  the  reader, 
and,  if  this  inquiry  is  continued,  others  will,  from  time  to  time, 
be  published. 

It  should  be  stated  that  the  medicines  employed  are  pre- 
pared by  Messrs.  Leath  and  Boss,  the  Chemists  to  the  Hospital. 

Case  1. 

Sore    Throat — Anna  Stevens,   aged  14,  admitted    October 

Ist,   discharged  October    18th.      Of  a  strumous  constitution. 

Two   years  ago  caught    cold,   had  sore  throat,  and  has  been 

affected  with  it  ever  since.     The  tonsils  are  very  much  enlarged^ 


184  Cases  treated  with  High  Dilutions. 

evidently  chronically  so — they  nearly  meet  and  fill  the  isthmus 
faucium,  and  greatly  impede  deglutition.  She  has  a  very 
peculiar  blowing  or  barking  cough — or  rather,  a  spasmodic 
expiration,  which  seems  to  be  associated  with  the  state  of  the 
throat.  Her  general  health  is  good.  The  house  surgeon  pre- 
scribed Acom'te  3  and  Mercurius  3  alternately  every  second  hour. 

From  the  3rd,  on  which  day  I  visited  her,  until  the  7th,  she 
had  Saccharum  lactis.  At  the  latter  date  she  is  reported  as 
having  less  inflanmiation  of  the  tonsils,  and  as  having  lost  the 
peculiar  expiration  above  described ;  but  she  complains  of  pain 
in  the  abdomen  and  has  no  appetite. 

Pulsatilla  200,  a  drop  ter  die. 

Oct.  9. — The  pain  continues,  and  is  of  a  shooting  kind. 
Mercurius  Corrosiv.  200,  a  drop  ter  die. 

Oct.  12. — The  pain  in  the  abdomen  has  disappeared,  but  she 
complains  again  of  the  pain  in  the  throat. 

Hepar  Sulphuris  200  :  ter  die. 

Oct.  14. — A  recurrence  of  pain  in  the  abdomen,  with  sour 
taste  in  the  mouth  of  a  morning. 

Mercurius  Corrosiv.  200  :  ter  die. 

Oct.  16. — No  pain.     Feels  quite  well. 

Case  2. 

George  Carle,  aged  37,  rheumatism.  Admitted  October  7; 
discharged  October  19. 

On  admission  says  : — He  got  wet  a  fortnight  ago  on  going  to 
work,  and  worked  in  his  wet  clothes  all  day.  In  the  evening  he 
was  seized  with  pain  across  the  shoulders,  and  in  all  his  limbs. 
Since  then  he  has  been  getting  gradually  worse ;  he  has  now 
pain  in  all  the  joints,  but  more  especially  in  the  ankles  and  the 
great  toes  :  these  joints  are  swollen,  tender  to  the  touch,  and 
painful  on  movement.  He  has  profuse  perspirations.  Pulse 
86,  skin  cool;  tongue  clean;  bowels  rather  costive.  Sleep 
much  disturbed  by  the  pains  in  his  joints,  which  are  worse  at 
night.     Heart  sounds,  normal. 

Aconite  200,  a  drop  every  four  hours. 


By  Mr,  YMham.  185 

Oct.  5th. — Better,  except  in  the  feet,  ^vhere  the  pains  are 

woise. 

Continue  Aconite  200. 

Oct.  Vth. — ^Is  worse;  pains  in  feet  more  acute.  Had  a 
sleepless  night     Pulse  90. 

Bryonia  200,  a  drop  every  three  hours. 
Oct.  9tL — Feels  better.     Pain  almost  gone  from  the  right 
foot,  and  is  now  confined  to  the  dorsum  of  the  left  foot,  which 
is  tender  and  swollen ;  skin  cool.     Pulse  80. 
Continue  Bryonia  200. 
Oct.  12th. — Pain  in  left  foot  easier,  except  when  attempting 
to  put  it  to  the  ground.     No  pain  last  night. 
Continue  Bryonia  200. 
Oct.  16th. — Much  better  in  every  respect.     Is  up  and  dressed, 
and  can  stand  without  much  difficulty. 

Continue  Bryonia  200. 
Oct.  19tL — ^Well.     Discharged. 

Case  3. 
Mary  Foot,  aged  40,  sore  throat.     Admitted  October  2  ;  dis- 
charged October  20. 

In  April  had  rheumatic  fever,  and  has  not  felt  well  since. 
On  Sunday  fortnight  was  seized  with  cold  in  the  head,  from 
sitting  in  a  draught.  Two  days  after  she  was  laid  up  with 
bronchitis,  and  has  been  ill  with  it  since. 

On  admission,  she  complains  of  aching  all  over ;  cough  of  a 
fotiguing  character  all  day,  with  dyspnoea ;  dull  aching  pain 
between  the  shoulders ;  throat  sore ;  tonsils  inflamed,  swollen, 
and  ulcerated ;  deglutition  painful ;  pulse  quick ;  no  appetite ; 
thirsty ;  respiratory  sounds  normal. 

Aconite  200,  a  drop  every  four  hours. 
Oct.  4th. — Pulse  100;  had  sleepless  night,  from   pain  in 
throat ;  cough  looser ;  less  pain  between  shoulders. 
Continue  Aconite  200. 
Oct.  5th. — Pulse  90;  restless  night;    tongue  foul;    tonsils 
free  of  ulceration,  but  stiU  red  and  inflamed. 

Belladonna  200,  a  drop  every  four  hours. 


186  CoMS  treated  with  High  Dilutions, 

Oct.  7th. — Had  rather  better  night ;  to-day  throat  more 
painful,  and  deglutition  more  difficult. 

Hepar  Sulphuris  200,  every  four  hours. 
Oct.  9th. — Throat  better ;  less  pain  after  swallowing. 

Continue. 
Oct.   12th. — Much    better;    throat    well;    has    pain    from 
epigastrium  to  back ;  worse  after  food ;  tongue  white. 
Pulsatilla  200,  a  drop  ter  die. 
Oct.  14th. — Pain  greatly  mitigated,  felt  only  occasionally. 

Continue. 
Oct.   19th. — Well,    as    regards    the    foregoing  attack;    has 
swollen  knees  from  chronic  rheumatism. 

Ehus  Tox  200,  ter  die. 

Oct.  25th. — Discharged  well;  with  the  exception  of  the 
knee  pains. 

Case  4. 

Edward  Dunn,  aged  4  7,  impetigo.  Admitted  October  5th  ; 
discharged  October  25th. 

About  a  month  since  an  eruption  appeared  on  the  outer 
side  of  the  right  arm,  and  on  both  feet  and  legs.  It  is  of  an 
impetiginous  character,  scabby,  mealy,  rough,  red,  and  raised 
on  an  inflamed  base  ;  it  itches. 

Ehus  Tox,  200,  ter  die. 
Oct.  13th. — The  scabs  cleared  off  the  arm.     The  eruption 
looks  much  better,  and  itches  less. 

Continue. 
Oct.  19tL — Continues  to  improve;  arm  almost  well;  feet  a 
little  swollen. 

Continue. 
Oct.   26th. — Has  been  progressing  favourably,  but  to-day 
there  is  a  little  more  roughness  and  redness  on  the  arm.     The 
other  parts  that  were  affected  are  quite  well. 
Sulphur  200,  ter  die. 
Oct.  28th. — ^Discharged  cured. 


By  Mr,  Yeldliam,  1S7 

Case  5. 
Jane  Bonnar,  aged  52,  gastric  irritation.     Admitted   Octo- 
ber 22nd  ;  discharged  November  lOtli. 

Was  in  Marylebone  Infinuary  for  bronchitis  for  six  montlis. 
She  left  in  May.  Since  then  has  been  badly  housed  and  fed. 
Three  weeks  ago  was  seized  witli  pain  in  stoniacli,  and  vomiting, 
which  has  continued  ever  since.  Slie  vomits  cventhinj'  alK)ut 
a  (j[Tiarter  of  an  hour  after  taking  it ;  the  ejected  matter  being 
sour  and  bitter,  and  green  looking.  Has  great  pain  in  tlie 
stomach  after  taking  food,  and  the  epigastrium  is  very  tender 
to  touch.  Anorexia ;  thirst  violent ;  headache  woi-se  at  night ; 
has  a  little  cough  ;  bowels  costive. 

Since  the  vomiting  commenced  she  has   been  living  in  a 

house  where  the  sewers  were  open,  and  painting  was  going  on. 

Tinct.  Aconite  200,  ter  die. 

Oct.  26th. — Has  not  vomited  since  beginning  the  medicine. 

Exquisite  tenderness   in    cardiac   region    on    pressure ;    pulse 

hard  and  incompressible. 

Continue  Aconite  200. 
Oct.  3  0th. — ^The  previous  symptoms  have  disappeared.     There 
is  catching  pain  under  the  lower  ribs  of  the  left  side,  shooting 
up  the  breast ;  worse  in  breathing  and  movement. 
Bryonia  200,  a  drop  every  four  hours. 
Nov.  2nd. — ^Well,  except  weak ;  takes  and  enjoys  food. 
Nov.  4th. — Saccharum  lactis. 
Nov.  10th. — Discharged  cured. 

Case  6. 
Jane  Staines,  aged  50,   hepatic  irritation.     Single,  a  cook. 
Admitted  October  22nd;  discharged  November  4th. 

Thirteen  days  ago  was  seized  with  vomiting.  Her  ejecta 
were  composed  of  "  blood  and  matter."  Some  hours  after  the 
vomiting,  was  seized  with  pain  in  the  region  of  the  liver,  which 
has  continued  ever  since. 

On  admission,  complains  of  dull  pain  in  right  hypochon- 
dricun,  worse  after  movement.  If  she  moves,  has  sharp,  shoot- 
ing pain  through  the  side ;  headache ;  pain  in  temples ;  heavi^ 


188  Cases  hy  Dr.  Drury, 

ness  over  the  eyes ;  appetite  fair ;  tongue  slightly  coated ; 
bowels  have  been  kept  open  by  purgatives.  Probably  had 
calomel  from  her  medical  attendant.  The  mouth  feels  sore ;  is 
blistered,  and  there  is  a  slight  mercurial  foetor ;  very  weak  and 
prostrated;  pulse  84;  skin  cooL  On  percussion,  the  liver 
does  not  seem  enlarged,  but  is  tender  on  pressure ;  stools  are 
generally  dark-coloured;  has  large,  foul,  chronic  ulcers  on 
both  legs.  Twenty  years  ago  had  jaundice. 
Bryonia  200,  a  drop  ter  die. 

Oct.  26th. — Much  the  same. 

Aconite  200,  ter  die. 

Oct.  28th. — Better  altogether;  pain  in  side  much  better, 
but  still  there. 
Continue  Aconite  200.     The  ulcers  on  the  leg  to  be  poulticed. 

Oct.  30th. — ^Altogether  much  better;  no  tenderness  on 
pressure  in  region  of  the  liver ;  tongue  clean ;  no  thirst ;  pulse 
normal. 

Nov.  2. — Continues  to  improve ;  general  health  pretty  good ; 
ulcers  healing  well. 

Saccharum  lactis. 

Nov.  4th. — Quite  well,  except  the  legs,  which  are  granu- 
lating healthily  and  rapidly.  Wishes  to  go  home.  Dis- 
charged. 


CASES  BY  WILLIAM  V.  DEUEY,   M.D.,  M.E.LA. 
Physician  Accoucheue  to  the  Hospital. 

Case  1. 

Dysmenorrhcea, — J.  F.,  a  servant,  aged  24,  admitted  as  out- 
patient July  12,  1863. 

Has  been  out  of  health  for  the  last  three  months ;  menstrua- 
tion returns  every  five  or  six  weeks.  The  quantity  is  large,  and 
is  passed  in  clots ;  suffers  during  the  period  from  bearing  down 
pain ;  complains  also  of  pain  in  head,  with  pressure  in  eyes ; 
also  pain  below  ribs,  increased  by  stooping,  believed  to  be 
flatulent. 


CaSMhyDr.Ih'ury,  189 

Sepia  30  in  solution  twice  a  day  for  three  days; 
then  to  stop  three  days,  and  repeat. 
July  26tL — Feels  better,  but  still  feels  the  pain  below  ribs. 

China  6-30,  I  twice  a  day. 
Aug.  1  Bth. — Called  to  report  liei'self  well. 

Case  2. 
Change  of  Lift, — Louisa  D.,  age  44,  admitted  as  out-patient 
June   28th,  1859.     Complains    of  violent  pains  in  back    of 
head.  Vertigo  aggravated  by  movement.    This  is  of  daily  occur- 
zence:  the  pain  in  head  is  a  heavy  bruised  pain.    Menstniation 
stops  for  two  or  three  months  :  about  a  month  ago  menses  were 
present ;  they  had  continued  on  and  ofif  for  five  or  six  weeks. 
Lachesis  6-30,  \  twice  a  day ;  Pulv.  ij. 
July  5th. — ^Much  better,  slight  giddiness,  but  weight  in  back 
of  head  and  neck  is  nearly  gone. 

Lachesis  6-30,  \  twice  a  day ;  Pulv.  ij. 
Omit  medicine  if  better. 
July  12th. — Omitted  medicine  when  she  felt  better,  but  re- 
sumed it  again,  as  there  was  some  return  of  headache ;  and 
again  obtained  relief. 

Continue  Lachesis. 
July  26th. — Is  now  generally  better,  had  omitted  the  medi- 
cine for  four  days,  but  resumed  it  again  on  feeling  some  return 
of  headache. 

To  continue  Lachesis  if  any  return  of  symptoms. 
Case  3. 
Headaches,  Jkc;  scanty  menstruation. — C.  M.,  age  36.  Mar- 
ried, has  two  children;  youngest  12.  Admitted  as  out-patient 
July  5,  1859.  Suffers  from  headache  before  and  during  men- 
struation ;  there  is  vomiting  and  pain  at  the  period.  Suffers 
from  debility.  Complains  of  pain  under  left  ribs.  Constipa- 
tion.    Menstruation  scanty,  often  absent. 

Pulsatilla    6-30,   J   twice   a   day; 
stop  three  days ;  repeat  twice. 
July  26th. — Burning  pain  over  eyes.    Sour  risings.    Beating 
in  head.     Bloated  feeling  after  food. 


190  Cases  ly  Dr.  Drury, 

China  6-30,  9  3  a  day.     Pulv.  iij  ;  discontinue  if  better. 
Aug.  16th. — At  first  much  relieved,  but   on  stopping  me- 
dicine some  return  of  symptoms. 

Eept.  China. 
Sept.  13th. — Improving. 

Phos.  Acid  7-20,  \  3  a  day.     Pulv.  ij. 

To  be  followed  by  China. 

Case  4. 

Cerebral  disturbance.     Convulsions. — Eachael  S ,  aged  one 

year  and  six  months,  admitted  as  out-patient  July  19,  1859. 
Five  or  six  weeks  ago  had  convulsions ;  during  fit,  and  while 
it  is  threatening,  right  hand  is  contracted.     Cheeks  flush,  then 
get  pale,  child  trembles. 

BeU.  6-30,j3aday. 
July  26th. — Nights  very  restless;  screams  out  suddenly  at 
night ;  sleeps  with  eyes  partially  open. 

Bell.  6-30,  I  3  a  day.     Pulv.ij. 
Aug.  9. — Much  better;,  perspires  very  much  about  head; 
:jontinues  to  get  thin. 

Acid  Phos.  30,  J  three  times  a  day,  six  days. 
Aug.  30th. — Child  is  all  but  well;  is  still,  however,  weak. 
Calc.  Carb.  30,  J  three  times  a  day. 

Case  5. 

Diarrhoea  after  food. — ^Amelia  H ,  age  1,  admitted  as 

out-patient  July  26,  1859. 

A  weak  and  sickly-looking  child ;  has  had  diarrhoea  for  three 
weeks;  has  had  thrush  for  nine  days;  evacuations  are  dark 
green,  and  are  generally  passed  after  taking  food,  which  also  seems 
to  produce  pain. 

Ferrum  6-30,  \  every  four  hours.     Pulv.  y. 
This  was  followed  by  Calcarea  Carb.  6-30,  i  3  a  day.     Some 
more  Ferrum  was  given. 

Aug.  2nd. — Improving;  takes  her  food  well;  has  pain  in 
stomach  at  night. 

Gale.  Garb.  6-30,  J  3  a  day. 


Cases  hy  Dr.  Drury.  J  91 

Aug.  9th. — Much  better,  but  Iiad  some  diarrlura  throuyli  the 
week;  the  evacuations  have  been  sour,  grei*iii.sli  antl  white  ;  hist 
two  rather  better. 

Cham.  30,  thrco  times  ii  <lay. 
Aug.  16th. — Improving.     Takes  her  fond  well;  but  bowels 
still  show  a  tendency  to  act  after  taking  it. 

Ferrum  30,  three  times  a  day. 
Aug.  30th. — Child  is  reported  well ;  looks  vciy  much  better; 
is  getting  fatter  and  stronger. 

Case    G. 
Eczema. — Eliza    T.,  age  68,    admitted  as   out-patient  July 
26th,    1859.     Has   suflfered  more   or  less  for  years  from  ill 
health,  but  for  last  three  months  has  suflered  much  from  an 
erythematous  patch  of  about  ten  inches  in  length  on  left  leg. 
There  is  much  itching.     There  are  also  red  patches  on  fingers, 
with   purulent    vesicular  eruptions.      She    has   herself   taken 
Shus,  Aeon,  and  Belladonna.     She  has  a  wet  rag  on  leg. 
Phos.  6-30,  6  twice  a  day.      Continue. 
Aug.   9. — Eather   better,  forefinger    of  right  hand  is  bright 
red   and  suppurating  over  knuckle.     The  itching  varies. 
Continue  Phos.  30,  twice  a  day. 
Aug.  23rd. — Improving. 

Continue  Phos. ;  but  to  stop  every  alternate  three  days. 
Sept.  13th. — Improving,  but  has  a  few  spots  on  the  right  leg  : 
the  eruption  seems  to  get  more  round  left  leg. 

Continue  Phos. 
Oct.    4tL — Improving,    still   much    itching,  stiU  uses  the 

wet  rag  to  leg. 

Continue  Phos. 
Oct.  25th. — Continues  to  improve  steadily. 

Case  7. 
Ba/iMda, — ^Louisa  W.,    age    28.     Admitted    as    out-patient 
July  5,  1859.     States  that  about  six  months  ago  she  noticed 
a  swelling  in  mouth  between  tongue  and  lower  jaw.    Continuing 


192  Cases  hy  Dr.  Ih^ry, 

to  increase  in  size,  she  sought  allopathic  advice.  The  tumour 
was  opened  and  burned  with  caustic,  without  effecting  a  cure. 
It  is  now  about  the  size  of  a  small  walnut.  Her  health  has 
been  moderately  good,  except  for  some  leucorrhoea,  attended 
with  smarting ;  and  that  she  suffers  from  pain  the  first  day  of 
menstruation. 

Carbo  Vegetabilis  2-30  daily  for  six  days ;  stop  three ; 
then  repeat. 
July  12th. — She  comes  sooner  than  expected,  as  she  says 
the  swelling  is  larger,  and  she  feels  sick,  and  trembles. 
Aut.  Crud.  6-30,  \  3  a  day. 
This  was  followed  by   Carbo  AnimaKs  2-30,  four  doses. 
July  26  th. — Swelling  has  increased  in  size. 

Mercurius  6-30,  J  3  a  day. 
This  treatment  was  continued  till  September  13,  without  any 
apparent  change ;  but  as  she  was  suffering  from  pain  during 
menstruation,  she  was  given  Pulsatilla  30. 
After  this  she  had  Thuja,  Ehus,  and  then  Mercurius  4-200, 

3  daily ;  stop  three  days  and  repeat. 
Nov.  22nd. — Eanula  smaller,  nausea,  wheezing  breathing, 
soreness  in  chest,  and  hoarseness. 

Hep.  Sulph.  9-30,  /o  3  a  day;  Pulv.  ij. 
Nov.  29th. — Chest  better,  but  is  suffering  from  headache. 

Kahnia  30. 
March  13th. — ^The  tumour  has  continued   to  decrease   in 
size,  and  is  now  about  the  size  of  a  pea. 

The  attendance  at  the  Hospital  had  ceased  from  November 
to  the  following  March ;  but  the  improvement  that  appeared  to 
have  commenced  under  Mercurius  200,  steadily  continued,  and 
by  April  24th  all  trace  of  ranula  was  gone. 

These  cases  have  been  selected  more  from  their  being  some 
of  the  earliest  in  the  case-book,  than  from  any  special  interest 
attaching  to  them ;  they  are  rather  imperfect  in  detail,  as  the 
notes  were  taken  more  for  the  sake  of  reference  to  the  medi- 
cines given,  than  with  a  view  to  their  publication. 


A  CASE  OF  EXTRA-UTEBINE  GEST^\  riOX. 

Bt  Mr.  Leadam. 

Mb.  Pbesident, 

I  bring  the  following  case  before  tlie  British  Ilomojo- 
pathic  Society,  in  the  hope  that  it  may  be  considei-ed  worthy  of 
being  recorded  in  its  transactions,  as  one  of  those  rare  casos 
which  give  additional  interest  to  the  study  of  gestation,  as  well 
in  its  abnormal  as  its  normal  progress.  Such  cases  are  instances 
of  the  natural  history  of  disease,  and  are  at  all  times  instruc- 
tive, if  not  remediable.  They  are  aids  to  diagnosis  in  other 
obscure  and  diflBlcult  cases,  and  indicate  the  eflforts  nature  in- 
stinctively makes  to  restore  the  equilibrium  of  the  natural 
processes,  when  accident  or  injury  has  disturbed  them.  Again, 
they  excite  a  great  amount  of  reflection  upon  the  means 
which  it  might  be  possible  to  adopt  in  similar  cases,  with  the 
hope  of  releasing  the  mother  and  the  child.  The  members  of 
the  Society  will,  I  am  sure,  not  be  slow  to  appreciate  any 
advantage  which  the  recording  of  such  a  case  may  bring. 

I  esteem  it  a  fortunate  circumstance,  that  in  a  case  of  such 
rare  occurrence,  and  of  such  an  abnormal  and  complicated 
character,  I  should  have  the  testimony  of  two  highly-respected 
members  of  this  Society,  as  to  the  correctness  of  the  descrip- 
tion I  have  given  of  the  case.  The  lady  was  a  patient  of  the 
President's,  to  whom  she  was  known  from  her  earliest  child- 
hood, and  also  to  Mr.  Cameron,  who,  at  various  periods  had 
attended  her  when  Dr.  Quin  was  ill  or  absent  from  home. 
Mr.  Cameron  was  also  present  with  the  eminent  physician- 
accoucheur,  and  professor  of  obstetrics,  and  his  son,  who  had 

VOL.  ni.  13 


194  Mr,  Leadam  on  Extra-Uterine  Gestation. 

been  several  times  consulted  at  the  post-mortem  examination, 
which  was  performed  by  Mr.  Eobinson,  at  that  time  house  sur- 
geon to  this  Hospital.  My  professional  services  were  engaged 
by  Dr.  Quin  for  the  period  of  accouchement;  but  several 
unusual  symptoms  showing  themselves  before  the  time  of 
parturition,  Dr.  Quin  became  desirous  that  an  examination 
should  take  place,  and  he  finally  associated  me  with  himself 
in  the  conduct  of  the  case,  and  I  had  thus  the  advantage  of 
his  counsel  and  co-operation  in  the  treatment  of  this  interesting 
case,  in  which  the  most  complicated  disturbances  arose  at 
different  times,  in  various  organs,  from  excessive  sympathetic 
irritation  during  the  progress  of  the  latter  months  of  the  gesta- 
tion.    The  following  history  wiU  show  the  progress  of  the  case. 

H.  M.,  aged  32,  had  been  for  some  time  in  indifferent  health 
previous  to  July,  1862,  the  catamenia  then  appeared,  and  ter- 
minated on  the  12th  of  that  montL  At  the  end  of  July,  she 
thought  herself  pregnant  from  the  similarity  of  her  sensations 
to  those  at  the  commencement  of  former  pregnancies.  Had  been 
married  eight  years,  and  had  several  miscarriages,  and  once  a  six 
months  pregnancy,  five  years  ago.  On  the  10th  of  August,  the 
catamenia  were  due,  but  did  not  appear.  About  this  time,  when 
driving  a  pair  of  ponies  in  the  country,  they  took  fright,  ran 
away,  and  although  the  pony-carriage  was  dragged  into  a  ditch, 
she  was  not  thrown  out,  but  shaken  about  and  frightened.  A 
slight  haemorrhage  occurred  per  vaginam,  for  which  she  was 
confined  to  the  sofa.  Early  in  December  quickening  was 
said  to  be  felt,  and  occasionally,  after  that,  for  two  months, 
gentle  but  distinct  movement  was  noticed.  Before  this,  how- 
ever, attacks  of  flatulent  colic  were  experienced.  In  conse- 
quence of  the  troublesome  persistence  of  these,  she  came  up 
to  London,  in  order  to  be  under  the  care  of  Dr.  Quin,  and  as 
an  occasional  flow  per  vaginam  took  place,  she  was  confined  to 
the  sofa. 

On  January  27,  I  first  saw  the  patient  with  Mr.  Cameron, 
and  made  the  following  report : — "  The  patient  is  in  constant 


Mr.  Leadamon  Extra-Uterine  Gestation  195 

dread  of  miscarriage,  haa  occasional  flow  per  vnginam  on 
any  exertion  or  incautious  movcmcut  innw  tlic  sufii.  Has 
repeated  attacks  of  flatulent  colic.  Eats  mcII.  The  ahdu- 
men  is  enlarged  to  rather  less  than  its  usual  size  at  this 
period  of  pr^nancy,  but  the  eulargeinent  is  not  central  and 
ovoid  as  it  should  be,  but  chiefly  on  the  left  side,  extend- 
ing to  the  umbilicus,  beyond  which,  to  the  right  side  there  is 
nnnsnal  resonance.  The  patient  thinks  she  fuels  occasionally 
slight  foetal  movement,  but  it  is  very  gentle.  The  nioveniont 
is  not  perceptible  to  any  other  person.  The  bowels  are  kept 
open  by  a  teaspoonful  of  castor  oil  taken  every  other  day. 
The  evacuations  are  large."  In  Felmiary  the  same  conditions 
existed,  but  there  was  increase  of  size;  some  tenderness  on 
firm  pressure,  and  slight  movement  was  felt  by  the  medical 
attendant  but  only  once.  I  thought  I  had  discovered  a  sub- 
dued placental  briiit  once  or  twice  thi'ough  the  stethescope, 
but  the  foetal  heart  was  not  distinguished.  Dr.  Quin  having 
charge  of  the  case,  asked  me  to  see  her  again  in  March,  when 
some  sanguinolent  discharge  per  vaginam  took  place,  of 
a  grumous  character,  and  which  continued  for  a  week.  It 
appeared  to  result  from  a  sudden  impulsive  movement  in  rising 
to  greet  a  visitor.  At  this  period  unduly  large  evacuations 
were  passing  from  the  bowels,  of  a  normal  consistence  and 
appearance.  The  abdomen  ceased  to  enlarge,  but  flatulent  dis- 
tress increased ;  the  urine  was  loaded  with  lateritious  deposit ; 
the  appetite  variable ;  there  was  midue  hardness  of  the  abdo- 
men, and  the  outline  of  a  fcetus  was  diagnosed  once  or  twice 
when  the  colon  was  less  distended  with  air,  wliich  at  other  times 
obscured  it  The  entire  colon  seemed  enormously  distended  with 
air,  and  its  transverse  portion  was  very  tender.  There  were 
frequent  eructations,  and  the  appolito  n)oro  fanciful.  At  the 
end  of  this  month  the  alvine  evacuations  continued  wonderfully 
large  in  quantity,  but  not  at  all  of  the  nature  of  diarrlicea. 

April  3rA — Good  Friday. — Eat  some   salt  fish  which  dis- 
agreed, and  produced  a  violent  attack  of  flatulent  colic.     The 

13* 


196  Mr,  Leddam  on  Extra-UteHne  Oestation. 

stomach  contiilued  in  a  state  of  great  irritability  for  three 
weeks,  with  great  general  distress  from  colics,  sleeplessness  and 
febrile  exacerbations  at  night,  for  which  aconite  was  given. 

The  treatment  for  the  foregoing  conditions  was  according  to 
the  symptoms.  Niuc  Vomica  for  the  flatulency;  Pulsatilla, 
Belladonna^  HyoscyamuSy  Yeratrwm,  Sdhina,  Con/mm,  for  the 
grumons  discharge  and  pain  in  the  left  ovarian  region,  &c. 

On  the  10th  of  April,  one  of  the  physician-accoucheurs 
formerly  referred  to,  saw  the  patient,  and  gave  his  opinion,  that 
however  great  the  sufferings  were  from  these  sympathetic  symp- 
toms, it  would  be  better  to  wait  the  normal  period  of  pregnancy 
without  interference.  There  was,  at  that  time,  a  grumous,  dark, 
and  occasionally  red  discharge  per  vaginam  on  and  off  for  two  or 
three  weeks.  The  symptoms  of  gastric  irritation  continued,  as 
well  as  the  tenderness  of  abdomen,  of  the  left  side  chiefly,  and 
the  tympanitic  distention,  flatulent  colics,  &c.  The  urine  was 
often  deep  coloured  and  turbid,  loaded  with  a  brick-dust  sedi- 
ment. Solid  food  was  refused;  chicken  panada  and  soups 
with  seltzer  water  and  champagne  formed  the  chief  diet. 

On  the  7th  of  May,  the  full  time  of  pregnancy  had  expired. 
A  careful  exploration  of  the  uterus  was  made.  The  os  uteri 
was  found  very  high  up,  but  by  great  effort  it  was  reached,  and 
found  patulous  and  relaxed,  but  the  inner  os  closed.  The  sound, 
carefully  used  entered  the  uterus,  but  on  attempting  to  turn  it 
a  resistance  was  felt.  The  attempt  was  inunediately  discontinued. 
There  was  at  this  time  milk  in  the  breasts,  which  by  pressure 
appeared  at  the  nipples.  On  the  9th  of  May,  the  other 
physician-accoucheur  saw  the  case.  After  a  careful  examination, 
he  declined  to  give  a  positive  opinion  till  after  another  visit. 

On  the  11th  of  May,  he  saw  the  patient  again  with  me. 
At  this  time  it  was  distressing  to  her  to  lie  on  either  side  :  it 
always  produced  an  attack  of  flatulent  colic.  The  case  was 
very  dark,  no  one  could  say  what  was  the  real  state  of  things ; 
there  were  symptoms  of  pregnancy,  but  no  child  could  be 
felt  in  the  uterus.  Air  in  the  intestines  seemed  to  predominate, 
yet  there  was  a  solid  mass  beneath  the  air  occupying  the  left 


Mr,  Leadam  on  Extra-Uterine  Oestation.  197 

side  of  the  abdomen.  The  countenance  ^ras  mucli  fallen  away 
and  exhibited  great  distress — general  attenuation.  She  wixs 
unable  to  bear  more  than  just  to  be  earned  from  the  bed  to  the 
80&  Sickness  was  now  frequent,  the  bowels  irregular,  and  a 
persistent  febrile  condition. 

After  this  examination,  on  the  next  day  there  was  an  accession 
of  inflammatory  fever — ^the  skin  burning  hot  Incn*asod  thirst 
and  tenderness  of  the  abdomen;  the  hands  burning, pulse  120. 
Exacerbations  at  night,  sleeplessness  and  a  diarrhoea  set  in 
of  blacky  offensive,  at  times  sanguinolent,  and  putrescent  evacua- 
tions. This  lasted  a  fortnight,  during  which  great  exhaustion 
occnnedy  and  the  evacuations  appeared  mixed  with  albuminous 
and  membranous  fibres,  but  so  intermingled  and  so  offensive 
that  the  nurse  would  not  separate  them.  I  saw  them  at  times, 
but  could  not  well  get  hold  of  the  matters  by  the  pieces  of  stick 
which  I  used.  At  the  end  of  a  fortnight,  about  four  inches  of 
a  cord-like  tubular  structure  was  passed,  as  weU  as  a  buucli  of 
firinge-like  matter.  These  were  washed  and  taken  to  St.  George's 
Hospital  Museum,  and  there  submitted  to  the  microscope, 
and  declared  to  he  intestinal  cast  and  a  mass  of  hlood  vessels. 
After  this,  the  evacuations  became  more  natural,  of  a  pale  brown 
colour,  and  the  diarrhoea  ceased.  One  teaspoonful  of  castor  oil 
was  given,  with  a  view  to  the  expulsion  of  any  more  of  the 
membranous  matters  there  might  be,  and  of  some  of  the  air 
from  the  intestines.  It  caused  sickness  and  increased  exhaus- 
tion, but  brought  nothing  abnormal  away. 

It  was  at  this  time  suggested  by  me  that  the  tubular  portion 
which  had  come  away  was  a  part  of  the  umbilical  cord,  and  the 
fiinge-like  tissue  a  part  of  foetal  placenta,  and  that  an  ulceration 
of  the  intestine  had  occurred  in  connection  with  the  cyst  through 
which  these  had  passed.  This  opinion  was  not  coincided  with 
by  the  phymcian-accoucheur  who  attended  along  with  me, 
for  he  thought  she  must  have  died  long  ago  if  such  had  been 
the  casa  After  this  the  abdomen  diminished  in  size,  much 
air  having  passed,  as  well  as  liquid  evacuations.     Ten  days 


198  Mr,  Lecidam  on  Extra-Uterine  Gestation. 

after,  the  nurse  observed  sometliing  protruding  at  the  anus 
after  evacuation,  which  receded  into  the  bowel  again.  The  finger 
was  passed  into  the  rectum  as  high  up  as  possible,  but  it  could 
not  be  found.  In  two  days  more  a  long  piece  of  the  same  tubular 
structure  was  passed,  resembling  umbilical  cord.  The  physician- 
accoucher  visited  the  patient,  but  did  not  agree  in  this  view.  It 
was  thought  now  that  some  fluctuation  was  felt  in  the  abdomen, 
but  it  was  indistinct.  At  times  the  tumour  could  be  felt  more 
defined  and  hard  in  the  left  side,  but  at  other  times  it  was  obscured 
by  the  tympanitic  distension.  After  this  the  symptoms  became 
more  and  more  grave,  the  vomitings  more  incessant,  gradual  ex- 
haustion set  in,  but  no  diarrhoea;  there  was  sleeplessness  and 
distress,  and  death  happened  on  the  17th  of  June,  two  months 
after  the  full  term  of  gestation  was  completed.  The  case  was 
watched  throughout  by  Dr.  Quin,  and  was  seen  at  times  by  Mr. 
Cameron  at  the  early  stages. 

Post'Mortem  Examination. — Great  emaciation  of  the  face  and 
extremities.  The  abdominal  parietes,  however,  contained  thick 
layers  of  adipose  tissue.  On  making  a  crucial  incision  at  the 
umbilicus  some  pus  was  observed  in  the  fossa  and  beneath  it. 
(During  life  the  nurse  had  observed  a  mattery  discharge  from 
the  umbilicus.)  On  raising  the  peritoneal  flaps  of  the  left  side 
we  found  the  body  of  a  female  child,  packed  very  close  in  a 
curvilinear  form,  with  the  head  lying  upwards  and  outwards, 
the  back  towards  the  left  outline  of  the  mother,  just  at  the 
crista  ilei.  It  was  of  the  size  of  an  average  foetus  of  six  or 
seven  months,  and  lay  in  a  sac  formed  by  thickened  peritoneum 
and  amnion  united,  aU  matted  in  with  the  abdominal  parietes. 
The  foetus  was  covered  by  the  usual  caseous  deposit ;  on  lifting 
it  up  from  this  bed,  the  umbilical  cord  was  found  broken,  but 
resting  at  the  aperture  of  a  large  ulcerated  opening  in  the  sigmoid 
flexure  of  the  colon.  It  corresponded  with  the  portions  of 
tubular  structure  which  had  passed  fmm  the  bowels.  The  foetus 
was  in  a  state  of  white  putrescence,  very  offensive,  but  firm, 
and  tightly  compressed,  of  a  drab  colour,  the  limbs  indented 


Mr.  Leadam  an  ExtrorUttriiu  Oestatim,  199 

one  with  the  other.  Through  the  ulcerated  opening  in  the  bo\i'el 
fSoeculent  matter  had  entered  the  sac,  the  edges  of  the  opening 
were  thickened.  The  sac  was  adherent  to  the  intestines  on  its 
posterior  aspect,  and  the  odour  was  highly  putrescent.  The 
foetal  placenta  would  seem  to  have  been  adherent  to  the  in- 
teatineB,  and  decomposing  to  have  caused  inflammation  and 
ulceration  into  the  bowel,  through  which  it  and  the  portions  of 
cord  first  found  had  exit,  and  thus  accounting  for  the  putrescent 
diarrhoea.  On  raising  the  foetus  in  order  to  remove  it,  no  attach- 
ment existed.  There  was  no  fluid  in  the  sac,  for,  on  the  day  of 
death  a  quantity  had  issued  per  rectum  and  saturated  the  bed. 
The  uterus  was  a  little  larger  than  normal  and  of  a  dark  purplish 
colour.  The  fallopian  tube  was  identified  at  its  junction  with 
the  uterus,  but  terminated  in  the  thickened  tissue  matted 
together.  The  foetus  was  taken  to  St.  George's  Hospital,  but 
was  thought  too  putrescent  for  any  further  examination,  and  was 
thrown  away  before  Hospital  visit  next  morning. 

The  preceding  case  appears  to  differ  from  the  greater  number 
of  cases  of  extra  uterine  gestation  which  are  recorded,  in  the 
fiEulure  of  any  natural  effort  to  get  rid  of  the  foetus,  or  to  pre- 
serve it  from  putrescence.  It  will  have  been  observed  in  the 
course  of  the  history  that  the  sympathetic  irritation  induced  in 
the  mother  was  evoked  at  an  early  date,  and  that  what  might 
be  called  the  conservative  effort  to  dislodge  it  from  its  abnormal 
position  took  place  posteriorly,  or  in  the  bowel,  and  therefore  at 
a  point  which,  whilst  of  necessity  it  must  prove  fatal  to  the 
mother,  equally  precluded  the  possibility  of  any  surgical  assist- 
ance. The  ulcerative  process  which  took  place  in  the  intestines 
of  course  admitted  the  intestinal  gases  into  the  sac,  and  to  this 
cause  alone  is  attributable  the  putrescency  of  the  foetus,  which 
so  long  as  it  was  encased  and  hermetically  sealed  in  the  cyst 
would  remain  for  any  length  of  time  free  from  septic  influ- 
ences. There  are  many  cases  of  this  accident  scattered  through 
the  transactions  of  the  difierent  medical  societies,  but  in  the 
44th  voL  of  the  "  Medico-Chicurgical  Transactions "  is  to  be 


200  Mr,  Leadam  on  Extra-Uterine  Gestation. 

found  a  very  interesting  account  of  one  case  upon  which  Mr. 
Adams,  of  the  London  Hospital,  operated  with  success  in  con- 
junction with  Dr.  Kamsbotham,  and  some  part  of  its  details  will 
I  doubt  not  be  interesting  to  the  Society. 

In  the  Museum  of  the  Eoyal  College  of  Surgeons  there  are 
only  five  specimens  of  extra-uterine  foetation,  and  from  these 
and  others  recorded  it  would  appear  that  the  fallopian  tube  is 
usually  the  seat  of  the  accident,  and  not  the  ovary. 

One  of  these  is  the  case  alluded  to  which  occurred  in  1860. 
A  patieut  was  taken  into  the  London  Hospital  under  Dr. 
Eamsbotham,  with  a  large  abdominal  swelling,  which  Dr.  Rams- 
botham  and  Mr.  Adams  considered  to  be  an  extra-uterine  foetus. 

"  M.  S.,  set.  28,  of  fair  complexion  and  middle  height,  and  with 
all  the  appearances  ofgood  health,  had  been  married  eight  years. 
She  had  always  menstruated  at  regular  periods,  but  had  never 
been  pregnant  before.  In  January,  1859,  she  menstruated  very 
profusely,  and  very  scantily  in  February.  From  March  until 
May  she  was  subject  to  occasional  attacks  of  severe  cramp-like 
pains,  which  were  confined  to  the  right  side  of  the  abdomen, 
extending  from  the  pelvis  to  the  hypochondrium;-  she  felt  very 
sick,  but  rarely  vomited ;  she  had  no  distinct  morning  sickness 
at  any  time.  After  February  her  menstrual  secretion  stopped, 
and  she  dated  the  commencement  of  her  pregnancy  from  the 
early  part  of  this  month.  In  June  she  first  felt  the  move- 
ments of  a  child,  and  her  breasts  perceptibly  enlarged.  This 
condition  continued,  and  after  some  time  she  observed  milk 
escaping  from  both  breasts,  more  particularly  the  left,  and  the 
veins  of  the  left  leg  and  thigh  became  varicose. 

"  She  continued  in  good  health,  her  abdomen  increased  in  size, 
and  she  distinctly  felt  the  movements  of  the  child  until  the 
30  th,  a  day  or  two  prior  to  which  she  had  a  heavy  fall,  which 
was  followed  by  soreness  and  cramp  down  to  her  knees.  She 
considered  herself  in  the  ninth  month  of  pregnancy,  and  ex- 
pected her  confinement  in  the  early  part  of  November.  She 
was  visited  by  Mr.  Williams,  surgeon,  of  Plaistov,  Essex.     On 


Mr.  Leadam  an  Extra-Uimru  Oestation,  201 

the  30th  of  October  she  leceiyed  a  severe  mental  shock  from 
her  sistei'a  death  At  this  time  she  ceased  entirely  to  feel  the 
moyements  of  the  child,  and  a  week  after  this  she  began  to  feel 
sleepy,  tired,  and  worn,  and  suffered  from  a  sense  of  stifihess  in 
her  limbs,  but  had  no  distinct  pains  like  uterine  pains.  A 
discharge  took  place  from  the  vagina,  and  blood  varying  in 
colour  &om  dark  to  pink,  and  pieces  of  flesh-like  substances, 
entirely  inoflfensive  in  odour,  were  expelled  in  gushes.  She 
reckoned  her  time  of  gestation  to  have  terminated  at  the  be- 
ginnlng  of  November.  From  this  time  she  gradually  diminished 
in  siza 

"In  January,  1860,  she  remained  in  much  the  same  state. 
In  February,  menstruation  recommenced,  and  it  has  continued 
r^^larly  ever  since,  varying  in  quantities,  and  usually  ex- 
pelled in  gushes.  The  milk  remained  in  her  breasts  until 
March  Latterly  she  had  become  much  thinner.  On  ex- 
amination a  hard  oval  tumour  was  felt,  particularly  on  the 
right  side  of  the  abdomen,  extending  from  above  the  umbilicus 
to  the  right  side  of  the  symphisis  pubis.  There  was  a  re- 
markable prominence  in  the  tumour,  which  was  quite  irre- 
znoveable,  and  very  unlike  any  swelling  from  a  fibrous  tumour 
connected  with  the  uterus.  The  hand  could  be  easily  passed 
around  the  greater  part  of  it,  and  the  abdominal  parietes  could 
be  made  to  glide  over  its  anterior  surface.  There  was  a  feeling 
of  irregularity  about  it ;  but  the  individual  portions  of  a  foetus 
could  not  be  recognised  distinctly,  for  there  was  a  good  deal  of 
subcutaneous  fet  in  the  walls  of  the  abdomen.  There  was  no 
pain  on  pressure.  The  uterus  was  found  by  examination  per 
vaginam,  to  be  rather  higher  than  usual,  but  there  was  no 
evidence  of  disease  in  it.  She  was  able  to  perform  her  usual 
domestic  duties,  and  expressed  herself  very  anxious  for  the 
removal  of  the  tumour.  There  could  be  little  or  no  doubt  as 
to  the  precise  nature  of  the  case ;  so  Dr.  Eamsbotham  and  Mr. 
Adams  agreed  that  the  operation  of  gastrotomy  should  be  per- 
formed, but  thought  it  prudent  to  allow  six  months  from  the 


202  Mr,  Leadam  on  Extra-Uterine  CfestaOon. 

end  of  what  was  supposed  to  be  the  natural  term  of  gestation 
to  elapse.  She  was  therefore  re-admitted  in  May,  and  being 
then  in  perfect  health,  and  fully  alive  to  the  risk  of  the  opera- 
tion, it  was  performed  by  Mr.  Adams  on  the  31st. 

I  avoid  the  minute  details  of  the  operation.     "  On  opening 
the   peritoneum    (five   inches   in  length),   the  surface  of  the 
tumour  presented  a  glistening  aspect,  and  was  only  slightly  ad- 
herent at  the  part.     The  cyst,  which  was  four  lines  in  thickness 
and  very  firm,  was  opened,  and  a  pint  of  a  greenish-yellow 
transparent  fluid  escaped,  with  yellowish  flakes  of  vemix  caseosa 
and  some  hairs.     As  soon  as  the  cyst  was  opened,  a  loop  of 
the  funis  protruded.     The  cyst  was   divided   on  the  finger,  to 
the  extent  of  the  opening  in  the  abdomen,  and  the  funis  being 
returned,  and  a  portion  of  the  rectus  muscle  divided  trans- 
versely, I  felt  the  head  and  body  of  a  foetus,  with  its  head 
uppermost,  and  its  face  towards  the  spine.     I  introduced  my 
hand  and  seized -an  arm,  which  I  pushed  back,   and  then  had 
no  difficulty,  owing  to  its  limp  state,  in  extracting  the  foetus 
by  the  breech.     The  funis  was  divided  so  as  to  leave  about 
two  inches  outside  the  incision.     On  traction  by  the  remaining 
part  of  the  funis,  it  was  clearly  ascertained  that  the  placenta 
was  firmly  adherent,  and,  under  the  advice  of  Dr.  Eamsbotham 
no  attempts  were  made  to  remove  it.     A  piece  of  omentum 
which  had  escaped  through  the  opening  was  cut  away,  and 
some  rather  large  arteries,  as  well  as  some  vessels  in  the  cut 
edges  of  the  cyst,  were  secured.     I  carefully  sponged  out  aD 
the  fluid  from  the  cyst,  the  walls  of  which  collapsed,  especially 
on  the  left  side.     Firm  adhesions  seemed  to  keep  the  right  side 
in  contact  with  the  abdominal  walls.     The  edges  of  tho  wound 
were  carefully  brought  together  by  interrupted  sutures,  carried 
only  through  the  integument  and  subjacent  fSat,  and  all  the 
parts  were  kept  in  apposition  by  careful  strapping,  padding  with 
cotton  wool  and  an  elastic  bandage.     After  the  operation  she 
became  extremely  fidnt,  but  was  restored  by  brandy.     She  went 
on  uninterruptedly  well.     The  funis,  which  on  its  first  appear- 


Mr.  Leadam  on  Extra-Utrine  Oestatian,  203 

ance  daring  the  operation,  was  thick  and  oedematons,  shrivelled 
np,  and  was  altogether  lost  sight  of  on  the  fifth  day  after  the 
operation ;  no  doubt  it  escaped  among  the  discharges.  There 
remained  for  some  time  a  small  fistulous  opening  with  ex- 
uberant granulations,  &c. 

"  With  respect  to  the  child  : — ^The  length  of  the  child  was  two 
feet,  the  weight  was  four  pounds  three  ounces.  The  urachus 
and  umbilical  vessels  were  open.  The  child  was  a  female  well 
developed.  The  cuticle  peeled  off  in  large  flakes ;  there  was 
no  offensive  odour.  The  head  was  well  covered  with  fine,  long, 
and  light  brown  hair ;  the  nails  were  long  and  well  developed. 
The  parietal  bones  were  slightly  displaced,  and  overlapped  by 
the  occipital  and  frontal  bones.  Both  comiae  were  opaque,  the 
eyes  shrunk.     No  vitreous  humour  was  found. 

"  No  opportunity  was  afforded  in  this  case  of  proving  the 
precise  situation  of  the  extra-uterine  foetus.  Whether  it  was 
developed  in  the  walls  of  the  uterus  or  in  the  abdominal  cavity 
by  attachment  of  the  ovum  to  the  peritoneal  surface  of  the 
intestines,  could  not  be  made  out." 

The  second  specimen  in  the  College  Museum  is  that  of  a 
woman  aged  thirty-six  (having  one  child),  who  in  the  fourth 
month  of  pregnancy  was  reaping  in  a  com  field,  and  carrying  a 
heavy  burden,  when  she  fainted,  and  was  carried  home ;  faint- 
ness,  but  little  pain  ensued,  and  she  died  the  next  day.  The 
middle  portion  of  the  left  fallopian  tube  was  dUated  into  an 
oval  cyst  filled  with  coagulated  blood.  In  the  anterior  wall  is 
a  ragged  opening,  through  which  the  foetus  had  burst,  and  had 
escaped,  and  is  seen  falling  through  into  the  pelvis,  which  was 
found  full  of  blood  coagulated.  The  uterus  was  enlarged  as  in 
the  early  stages  of  pregnancy,  and  was  said  to  have  had,  when 
recent,  a  deciduous  membrane ;  the  os  uteri  was  closed  by  a 
gelatinous  exudation. 

The  third  case  shows  the  right  fallopian  tube  dilated  into  a 
BBC,  about  one  inch  and  a-half  in  diameter  near  to  its  extremity, 
and  opened,  to  show  a  small  foetus  (six  or  eight  weeks)  budding. 


204  Mr,  Leadam  on  Extra-Uterine  Oestation. 

the  face  distinct,  and  the  extremities  just  evolving.  There  is 
no  increased  vascularity  in  the  uterus. 

The  fourth  case  is  the  section  of  a  full-sized  foetus,  which 
after  arriving  at  maturity,  had  been  retained  over  fifty-two  years 
in  utero,  enclosed  in  a  sac,  which  had  become  ossified.  The 
foetus  was  roUed  up  and  compressed  into  a  firm  globular  mass. 
The  parts  of  the  foetus  which  lay  external  or  towards  the  sur- 
face of  the  cyst,  became  absorbed  down  to  the  bone,  while  the 
muscles,  &c.,  situated  towards  the  interior,  were  soft  and  natural 
After  aU  these  years  the  limbs  were  partially  unfolded,  and 
there  were  no  signs  of  decomposition. 

The  fifth  case  is  that  of  a  condensed  and  ossified  foetus,  which 
had  been  retained  in  the  abdomen  fourteen  years  beyond  the 
ordinary  period  of  gestation.  It  was  in  a  museum  in  Ham- 
burg before  it  was  brought  to  the  College  of  Surgeons. 

The  foetus  is  almost  completely  developed,  but  compressed 
and  dried,  so  that  little  more  than  the  bones  remain  to  indicate 
its  previous  form.  It  is  reduced  to  a  flattened  irregular  mass, 
about  four  inches  long,  by  from  two  to  three  inches  wide. 

The  foetus  was  removed  by  operation,  as  was  believed,  from 
the  fallopian  tube.  The  patient  recovered,  and  lived  a  long 
time  after  in  Hamburg. 

Dr.  Wm.  Campbell,  of  Edinburgh,  in  a  memoir  on  extra- 
uterine gestation,  published  in  1843,  details  nineteen  cases  in 
which  the  foetus  remained  in  the  abdomen  of  the  mother  during 
a  period  varying  from  two  to  fifty-six  years,  and  he  refers  to 
several  cases  in  which  the  mothers  so  circumstanced  conceived 
once;  two  cases  in  which  the  mothers  bore  two  children,  four 
cases  in  which  three  children  were  bom,  two  instances  of  five 
birtlis,  and  one  case  where  the  mother  gave  birth  to  six  children, 
whilst  an  extra-uterine  foetus  remained  in  the  abdomen. 

However,  he  remarks,  that  "  except  in  some  rare  cases,  sooner 
or  later,  in  consequence  of  many  causes,  which  may  or  may  not 
bo  obvious,  inflammation  arises  in  the  adjoining  organs,  in- 
volving the  envelope  of  the  foetus."     In  those  cases  which  have 


Mr,  Leadam  on  Extra-Uteriiu  Oestatian.  205 

remained  innocent  for  so  long  a  time,  nature  converts  the  cyst 
contaimng  the  foetus  into  a  material  not  readily  acted  on,  which 
constitutes  a  permanent  covering,  ossification  of  the  cyst  takes 
plaxse,  or  the  foetus  undergoes  a  sort  of  petrifaction,  by  which  it 
is  converted  into  cartilage  or  bone,  and  is  materially  reduced  in 
voluma 

Numerous  instances  are  on  record  where  the  foetus  has  been 
got  rid  of  by  ulceration  into  the  vagina,  rectum,  colon,  bladder, 
as  well  as  by  abscess,  opening  externally,  either  at  the  umbilicus 
or  some  other  part,  of  the  abdominal  walls. 

It  is  most  probable  that  in  all  such  cases,  the  decomposition 
and  subsequent  disintegration  of  the  foetus  have  preceded  the 
efforts  of  nature  to  evacuate  the  contents  of  the  cyst;  for 
when  the  foetus  has  been  extracted  entire,  however  long  a  period 
m&j  have  elapsed  after  the  termination  of  natural  gestation,  no 
decided  evidences  of  putrefaction  have  been  found.  In  a  case 
quoted  by  Dr.  Eamsbotham  (in  his  "  Principles  and  Practice  of 
Obstetric  Surgeiy "),  where  a  foetus  was  removed  by  incision, 
which  had  evidently  remained  eight  years  in  the  abdomen  of 
the  mother,  it  was  in  "  an  astonishing  state  of  preservation." 
(The  case  is  given  in  the  Medico-Chirurgical  Review  for  1834.) 
A  fistulous  opening  was  formed  at  the  umbilicus,  which  was 
enlarged,  and  the  foetus  removed.  In  another  case  referred  to 
by  Mr.  Adams,  the  patient  declined  an  operation  at  the  very 
time  when  surgical  interference  was  called  for,  and  she  died, 
worn  out  by  diarrhoea  and  hectic. 

DISCUSSION. 

Mr.  Cameron. — ^The  lady  whose  melancholy  case  Mr.  Leadam 
has  so  well  described,  was  well  known  to  me  for  many  years,  and 
I  frequently  attended  her  when  Dr.  Quin  (her  physician  from 
her  childhood)  was  ill  or  out  of  town.  I  was  called  to  see  her 
on  the  14th  January,  1863,  and  continued  in  attendance  during 
the  remainder  of  that  month,  during  his  absence  in  the  country, 
where  he  was  detained  by  illness.  Before  he  left  London  he  had 
arranged  with  the  patient  and  her  friends,  that  Mr.  Leadam  was 


206  Mr.  Leadam  on  Extra-Uterine  Gestation. 

to  attend  her  in  her  accouchement,  and,  as  some  puzzling  and 
anomalous  symptoms  connected  ifith  her  pregnancy  showed 
themselves,  I  obtained  her  consent  to  my  having  a  consultation 
with  that  gentleman,  and  accordingly  we  met  on  the  27th  Janu- 
ary. Two  days  afterwards.  Dr.  Quin  returned  to  London,  and  I 
ceased  my  attendance.  From  my  interest  in  the  patient  and  in 
the  case,  I  was  able  afterwards  through  conversations  with  Dr. 
Quin  and  other  friends,  to  watch  the  progress  of  the  illness  pretty 
accurately,  and  from  having  been  present  with  other  medical 
men  at  the  post-mortem  examination,  I  am  in  a  position  to  bear 
full  testimony  to  the  correctness  of  Mr.  Leadam's  report  of  the 
case. 

Dr.  Druey  had  listened  with  much  interest  to  the  details  of 
Mr.  Leadam's  well  reported  and  instructive  case,  one  of  a  class 
of  cases  more  frequently  heard  of  than  seen,  as  from  their  great 
rarity  they  were  unknown  to  many  practitioners  except  from 
books ;  Dr.  Drury's  own  knowledge  being  gathered  from  such 
sources  he  felt  a  hesitation  about  saying  anything,  but  being  ap- 
pealed to  by  the  President,  he  availed  himseK  of  the  opportunity 
of  thanking  Mr.  Leadam  for  having  so  faithfully  preserved  the 
history  of  the  case.  He  at  the  same  time  conamended  the  judg- 
ment of  the  gentlemen  in  attendance  that  led  them  during  the 
life  of  the  patient  to  form  an  opinion  as  to  the  nature  of  the  case 
which  was  afterwards  borne  out  by  post-mortem  appearances. 
In  this  particular  case  the  question  of  obtaining  relief  by  operative 
interference  may  not  have  arisen,  but  in  these  days  of  bold  and 
successful  operations,  the  medical  attendant  should  always  be  alive 
to  the  chances  of  saving  life  afforded  by  a  timely  and  well-planned 
operation.  It  unfortunately  too  often  happened  that  the  golden 
opportunity  was  lost  by  a  hesitancy  about  operating  even  where 
such  a  step  was  inevitable  if  life  was  to  be  saved.  At  times 
also  this  was  deferred  without  sufficient  reason,  till  the  patient's 
strengtli  was  so  much  reduced  that  the  hopes  of  success  were  much 
diminished.  A  case  had  arisen  last  year  in  Allopathic  practice 
that  caused  much  controversy,  but  which  helped  to  illustrate  the 
point  that  he.  Dr.  Drury,  alluded  to,  it  was  that  of  a  medical 
man  at  Tunbridge  Wells,  suffering  from  obstruction  of  the  in- 
testinal canal,  some  of  those  who  saw  the  case  wished  to  practice 
Amusset's  operation,  but  others  objected  because  there  still  some 
small  amount  of  foeces  passed,  so  that  there  was  not  total  obstruc- 
tion; the  non-interference  men  carried  their  point,  and  the  patient 
died ;  now,  in  this  case,  had  an  operation  been  performed  life 
might  have  been  prolonged  for  a  year  or  two.  In  the  cases  im- 
mediately imder  consideration,  even  when  their  true  nature  was 
recognized,  no  rule  could  be  laid  down  for  interference,  as  from 
their  known  terminations  the  point  could  only  be  settled  on  the 


Mr,  Leadam  on  Extra-Uterine  Gestation,  207 

merits  of  each  particular  case.  It  sometimes  happened  where 
extra^uterine  foetationhad  taken  place  that  the  immediate  danger 
passed  over,  and  subsequent  pregnancies  tenuinating  naturally 
and  favourably  took  placa  A  case  occurred  in  the  practice  of  Dr. 
M.  W.  MiiUer,  of  Hohenweihr,  where  a  hernial  tumour  was  found 
to  increase  in  size  as  pregnancy  went  on,  and  which  was  ulti- 
mately opened,  the  cmld  and  placenta  being  extracted,  but 
imliappily  the  patient  sank  from  internal  haemorrhage.  Writers 
generieJly  classified  extra-uterine  foetation  imder  three  heads, 
ovarian,  tubular,  and  interstitial,  the  tubular  being  the  most 
frequent  In  Mr.  Leadam's  case  the  mischief  would  appear  to 
have  been  connected  with  the  ovary;  it  was  a  question  how 
txr  the  early  history  of  the  case  threw  a  probable  light  on  the 
cause  of  the  evil,  for  from  the  state  of  health,  &c.,  prior  to  preg- 
nancy, the  pathological  change  most  probably  then  took  place, 
pr^nancy  being  prevented  following  the  ordinary  course  by  what 
nad  existed  for  some  time.  Dr.  Campbell  had  collected  some 
valuable  statistics  of  this  accident,  showing  that  the  foetus  might 
be  retained  without  destroying  life  for  a  period  varying  from 
months  to  many  years.  The  nope  of  the  foetus  being  expelled 
either  through  the  abdominal  parieties  or  through  the  bowels, 
was  necessanly  uncertain,  but  happening  sufficiently  often  to  give 
hope  when  such  an  action  was  set  up  that  it  might  terminate  favour- 
ably. The  passing  a  portion  of  the  umbilical  cord  was  a  first 
effort  in  the  present  case  towards  a  removal  by  the  bpwels.  Not 
liaving  experience  of  his  own  to  relate  Dr.  Drury  would  not 
trespass  longer  on  the  time  of  the  Society. 

The  President,  in  bearing  full  testimony  to  the  accuracy  and 
exactitude  of  the  description  of  the  sad,  but  extremely  rare  case 
just  read  to  the  Society  by  Mr.  Leadam,  said,  that  the  subject  of 
it,  from  her  infancy  up  to  the  period  of  her  marriage  had,  in  all 
the  illnesses  incidental  to  cluldhood  and  youth,  been  treated 
Homoeopathically.  On  her  marriage  she  removed  from  London, 
and  resided  abroad  for  some  years,  and  afterwards  in  the  country, 
and  there  being  no  Homoeopathic  practitioner  in  the  neighbour- 
hood, she  was  generally  treated  Allopatliically,  except  occasionally, 
while  in  London.  Although  several  times  pregnant,  no  child 
was  bom  alive, — ^miscarriages  each  time  having  taken  place  early, 
with  one  exception,  about  three  years  ago,  when  the  child  was 
six  months  old.  About  a  year  and  a-half  before  her  last 
pregnancy,  of  which  they  had  just  heard  the  history,  she  had  a 
very  dangerous  attack  of  diptheria ;  this  was  followed  a  short 
time  after  by  ulceration  of  the  womb,  which  was  treated  locally 
by  injections  and  cauterization,  and  internally  by  alteratives  and 
tonics,  by  the  Allopathic  physician-accoucheur  then  in  attend- 


208  Mr,  Leadam  on  Extra-Uterine  Oestation. 

ance.  To  this  succeeded  ulceration  of  the  rectum,  which  assumed 
so  serious  a  character,  that  an  eminent  surgeon  was  associated 
with  the  above  gentleman  in  the  treatment  of  the  case.  Her 
health  deteriorated  greatly,  she  became  much  emaciated,  she 
imderwent  great  pain  and  discomfort  from  the  local  treatment 
pursued,  which  brought  on  two  severe  attacks  of  erysipelas,  which 
aggravated  greatly  the  pains  in  the  rectum.  A  highly  nervous, 
excitable,  and  irritable  state  supervened,  accompanied  by  symp- 
toms of  a  hectic  character,  and  inability  to  move,  sit  upright,  or 
stand  without  suffering  or  violent  paroxysms  of  pain  in  the 
rectum.  Her  own  family  became  alarmed  and  interfered,  and  her 
earnest  wish  to  return  to  the  treatment  she  had  been  accustomed 
to  from  her  childhood,  was  acceded  to  by  her  husband  and  his 
family,  and  he  (Dr.  Quin)  was  sent  for.  Under  the  action  oi Aconite 
Belladonna,  Arsenicum,^  vxVomica,  Ignatia,BJid  Hepar  Sulphuris, 
with  occasional  doses  of  Chamomilla,  Coffea  and  Hyoscyamus,  all 
the  painful  and  distressing  symptoms  gradually  disappeared,  the 
fever  abated,  the  appetite  and  sleep  were  restored,  and  the  power, 
of  moving  without  provoking  pain  or  bringing  on  a  relapse 
returned.  She  was  able  to  walk,  and  take  long  drives  into  the 
country,  and  drive  over  the  stones  in  town  without  bringing  on 
pain,  which  she  had  not  been  able  to  do  for  months.  She  was 
sent  into  the  country  for  change  of  air,  to  assist  in  restoring  her 
strength  and  recovering  her  flesh.  Just  at  this  period,  before  she 
had  recovered  the  full  tone  of  her  former  good  health  and  pre- 
vious healthy  constitution,  she  unfortimately  became  again 
pregnant.  He  had  entered  much  more  at  length  into  these 
details  than  he  would  have  done,  because  he  baew  the  early 
history  of  the  case,  and  because  he  was  of  opinion  that  the 
accident  mentioned  by  Mr.  Leadam,  or  rather  shock  which  her  sys- 
tem had  received  from  being  ran  away  with  in  her  pony  carriage 
had  nothing  to  do  with  the  extra-uterine  foetation.  This  he  believed 
must  have  occurred  within  the  first  ten  or  fourteen  days  of  her 
pregnancy,  which  state  of  pregnancy  had  been  communicated  to 
him  by  letter  a  considerable  time  before  the  ponies  ran  away 
with  her.  He  thought  it  was  more  probable  that  the  reduced 
state  of  her  health  from  the  long  and  severe  suffering  and  illness 
she  had  experienced  from  the  disease  in  the  womb  and  in  the 
rectum,  had  contributed  to  the  misfortune  which  had  terminated 
in  death.  From  the  very  earliest  period  of  gestation,  threatening 
symptoms  set  in.  On  the  14th  of  September,  the  medical  prac- 
titioner in  the  country  where  she  was  staying,  reported  to  him 
(Dr.  Quin)  as  follows.  "  I  first  saw  her  on  the  9th,  when  she  com- 
plained of  pain  and  a  sensation  of  weight  about  the  pubis  and 


Mr.  Leadam  on  Eoctra-Uterine  Oestation,  209 

acarum ;  there  was  a  rather  brownish-coloured  discharge  from  the 
vagina^  which  she  mentioned  had  occurred  at  intervals  during  the 
pievioos  week  or  ten  daya  This  discharge  had  not  at  all  the  ap- 
pearance of  the  catamenia,but  resembles  that  which  frequently  pre- 
cedes an  abortion.  These  symptoms  had,  on  the  12tli,  in  a  great 
measore  subsided,  by  perfect  rest  on  the  sofa  and  small  doses  of 
Hyosyamus.  When  on  the  13th,  she  was  seized  with  severe 
pain  in  the  muscles  of  the  chest  and  abilomen,  accompanied 
with  occasional  vomiting,  great  thirst,  and  great  distention  from 
wind.  The  discharge  from  the  vagina  is  nearly  gone,  but  there 
is  still  a  sensation  of  great  weight  at  the  lower  part  of  the 
abdomen.  You  are  aware  that  it  is  now  more  than  nine  weeks 
since  there  was  a  discharge  of  a  decidedly  catamcnial  charac- 
ter." These  symptoms,  he  learnt  from  subsequent  reports  wliich 
were  sent  to  him  (Dr.  Quin),  frequently  recurred,  accompanied  by 
much  pain  and  discomfort  in  the  left  side  in  the  ovarian  region, 
notwithstanding  she  was  kept  as  much  as  possible  in  the  re- 
cumbent posture.  Every  exertion  and  attempt  to  move  pro- 
voked a  recurrence  in  a  violent  form  of  these  painful  and  dis- 
tressing attacka  Towards  the  beginning  of  December,  1862, 
she  was  brought  to  town  to  be  under  his  (Dr.  Quin's)  imme- 
diate care  and  treatment  until  the  time  for  parturition  ap- 
proached. Subsequently  the  suspicious  and  anomalous  symptoms 
differing  from  those  usual  in  natural  and  healthy  gestation,  made 
me  desirous  of  associating  Mr.  Leadam  with  me  in  the  treatment 
of  this  complicated,  and  at  that  time,  obscure  case,  earlier  than 
in  ordinary  circumstances  would  have  been  necessary ;  and  it  is 
but  justice  to  him  to  state  that  after  making  the  requisite  local 
examinations,  his  diagnosis  of  the  case  from  the  time  that  the 
usual  period  for  parturition  had  elapsed,  and  even  for  some  time 
before,  was  justified  by  the  subsequent  events  and  by  the  post 
mortem  examination.  As  may  easily  be  imagined,  in  such  a 
complicated  state  of  organic  disease  as  latterly  existed,  the  sym- 
pathetic irritation  of  the  nervous  system  and  disturbance  of  the 
digestive  organs  became  more  distressing,  and  the  pains  at  times 
were  dreadfully  acute,  whilst  the  treatment  and  conduct  of  the 
case  increased  in  difl&culty.  The  patience  of  the  poor  sufferer  was 
most  touching,  and  greater  than  could  be  supposed  possible  by 
any  one  who  had  not  witnessed  it.  In  all  her  acute  sufferings  and 
distress  she  never  lost  confidence  in  Homoeopathy,  and  even 
up  to  the  last  she  resisted  every  attempt  at  persuasion  to  have 
recourse  to  Allopathic  treatment,  which  some  well-meaning 
friends,  who  ignorant  of  the  real  nature  of  her  state,  and  dis- 
posed to  attribute  her  danger  to  the  want  of  efficacy  of 
Homoeopathy,  had  endeavoured  to  induce  her  to  do.  With  re-. 
VOL.  in.  14 


210    Mr.  Cutmore  on  sorne  Morbid  Affections  of  the  Ear, 

spect  to  the  observations  of  Dr.  Drury  in  relation  to  an  opera- 
tion in  this  case,  it  was  the  opinion  of  all  the  medical  men 
who  had  seen  the  patient,  that  such  an  attempt  was  inadmis- 
Bable,  and  could  only  have  increased  her  sufferings  and  ac- 
celerated the  fatal  issue.  The  autopsia  proved  how  correct 
was  this  conduct  of  her  medical  advisers,  seeing  the  adhesions 
that  had  taken  place  and  the  ulceration  communicating  from  the 
sac  formed  in  the  fallopian  tube  or  left  oviary  through  the  peri- 
toneum to  the  sigmoid  flexure.  In  the  earlier  part  of  these 
observations,  he  (Dr.  Quin)  had  stated  his  disbelief  that  the 
shock  of  the  pony  carriage — ^being  landed  in  a  ditch — ^had 
anything  to  do  with  the  extra-uterine  fcetation,  and  he  was 
disposed  to  agree  with  Dr.  Drury,  that  mental  causes  and 
deteriorated  health  were  more  likely  to  lead  to  such  abnormal 
cases  of  conception  than  physical  shocks  or  accidents.  Fortu- 
nately such  cases  as  the  one  brought  under  the  consideration  of 
the  Society  this  evening  are  very  rare,  this  is  sufl&ciently  proved 
by  the  few  instances  on  record  collected  from  various  countries 
and  extending  over  a  very  long  period  of  time. 


ON"  SOME  MOEBID  AFFECTION'S  OF  THE  EAR. 
By  Charles  Cutmore,  Esq.,  M.RC.S.  &  L.M.  Eng. 

Gentlemen, 

Before  I  speak  of  the  general  treatment,  I  will  describe 
the  Anatomy  and  Pathology  of  the  Internal  Ear,  merely  with 
the  view  of  facilitating  and  simplifying  the  mode  of  treatment 
of  the  morbid  structures  connected  with  the  organ  of  hearing. 
It  is  to  be  regretted  that  our  Materia  Medica  is  so  barren 
in  objective  symptoms,  relating  to  diseases  of  the  ear,  of  which 
the  great  majority  only  can  be  diagnosed.  The  diseases  of  that 
organ  principally  arise  from  an  altered  state  of  their  natural 
structures,  and  are  only  recognised  by  the  eye,  ear,  and  touch, 
whilst  the  subjective  symptoms  express  pain,  pressure,  fulness 
and  noises  in  the  ears,  arising  from  a  disordered  state  of  the 
portia-mollis,  chorda  tympani,  anoemia,  or  congestion  of  the 


Mr,  ChUmore  on  some  Morbid  Affections  of  the  Ear.    211 

vessels  supplying  those  parts,  upon  which  very  little  reliance 
can  be  placed  in  regard  to  their  efiicient  treatment ;  the  diag- 
noslB  must  then  really  rest  upon  those  objective  and  more 
trustworthy  symptoms.  The  various  diseases  of  the  ear  are 
generally  devoid  of  any  symptoms  for  the  surgeon's  guidance  of 
treatment,  and  depend  in  many  instances  u^KDn  morbific  changes 
which  are  only  curable  by  constitutional  treatment,  while 
others  are  relieved  by  the  local  application  of  remedies  to  the 
Yaiious  structures. 

I  shall  first  mention  some  alterations  of  the  structures  which 
are  liable  to  become  diseased,  or  altered  from  the  normal  state, 
and  produce  deafness  : — 

1st.  The  diseases  of  the  ceruminous  glands. 

2nd.  Acute  and  chronic  inflammation  of  the  dermoid  meatus 
which  generally  terminates  in  polypus. 

3rd.  Polypus. 

4th.  Exostosis  of  the  external  meatus. 

5tL  Diseases  of  the  membrana  tympani. 

6th.  Obstruction  of  the  eustachian  tube. 

7th.  Diseases  of  the  cavity  of  the  tympanum. 

8th.  Disease  of  the  mastoid-ceUs. 

9tL  Nervous  deafness. 

The  Ceruminous  glands  are  about  the  size  of  millet  seeds, 
placed  exteriorly  to  the  dermoid  meatus,  in  the  interstices  of  a 
reticulated  membrane;  the  cerumen  they  secrete  is  useful  in 
keeping  the  canal  of  the  meatus  and  the  membrana  tympani  in 
a  state  of  moisture,  necessary  for  health,  and  to  transmit 
sonorous  sounds.  On  examining  the  ear  when  in  a  healthy 
condition,  you  will  find  a  ceruminous  circle,  consisting  of  fine 
hairs,  covered  by  a  sort  of  glutinous  dew;  but  in  a  diseased 
state  of  those  glands  it  is  absent,  and  presents  an  accumulation 
of  hardened  wax,  which  fiUs  up  the  meatus,  causing  pressure 
upon  the  membrana  tympani,  and  giving  rise  to  deafness, 
vertigo,  noises  in  the  head,  and  very  often  producing  s}Tnptoms, 
in  highly-nervous  persons,  similar  to  pressure  on  the  brain,  from 

14* 


212     Mr,  Cutmore  on  some  Morbid  Affections  of  the  Eixo'. 

the  hardened  mass  pressing  upon  the   ossicles   through   the 
membrana  tympani  against  the  contents  of  the  vestibule. 

The  treatment  in  such  cases  is  simple.  I  will  relate  one  of 
many  that  have  come  under  my  care. 

Case. 

Abraham  Shilling,  aged  63,  fisherman  at  Dover.  For  many 
years  had  suffered  with  deafness,  also  vertigo  and  violent  noises 
in  the  head  and  ears  (nearly  depriving  him  of  his  livelihood  on 
account  of  his  deafness).  Examined  the  meatus  with  the 
speculum  and  discovered  a  hard,  black-looking  mass,  which  on 
being  touched  caused  great  pain  in  the  head ;  he  also  expressed 
that  he  had  not  been  able  to  lie  on  the  affected  side  for  years 
without  feeling  distressed ;  the  hearing  distance  of  the  watch  was 
contact.  Syringed  the  meatus  with  warm  soda-water,  which 
brought  away  a  hardened  mass  of  cerumen  and  epidermis, 
leaving  the  meatus  absorbed,  red,  and  granulated ;  touched  the 
meatus  with  a  solution  of  Arg.  nit.  gr.  x  aquse  5,  with  a 
camel-hair  brush ;  the  hearing  distance  increased  three  feet  (that 
being  the  normal  standard),  and  the  whole  of  the  unpleasant 
symptoms  left  him. 

There  is  another  disease  which  affects  the  ceruminous  glands, 
viz.,  a  deficiency  of  wax.  This  generally  happens  to  persons 
disposed  to  rheumatism  and  of  a  gouty  diathesis,  chlorotic 
females,  and  those  suffering  from  long  continuous  discharges, 
viz.,  leucorrhoea,  haemorrhoids,  &c. ;  also,  the  disease  arises  from 
a  diseased  condition  of  the  throat  and  tonsils^  which  occurs  in 
a  scrofulous  diathesis. 

The  treatment  here,  must  be  entirely  constitutional,  and 
vary  with  the  peculiar  idyosyncrasies  of  the  patient,  so  as  to 
restore  a  healthy  secretion  of  the  glands. 

I  have  foTmd  Spongia  an  excellent  remedy  where  there  is  a 
total  deficiency  of  wax.  I  will  now  pass  on  to  another  disease 
of  a  more  serious  nature,  viz.,  acute  and  chronic  inflammation 
of  the  dermoid  meatus.  This  membrane  is  subject  to  inflamma- 
tion from  many  causes,  such  as  the  accidental  introduction  of 


Mr,  Outmore  an  some  Morbid  Affections  of  the  Ear.     213 

any  foreign  body,  an  accumulation  of  cerumen,  the  ap])li- 
cation  of  cold  or  heat,  arising  especially  from  a  sudden 
change  of  temperature  in  the  weather,  or  any  debilitating  ill- 
ness. The  symptoms  of  the  inflammation  are  similar  to  those 
which  attack  any  other  part  of  the  body,  added  to  a  sensation 
of  fullness  and  uneasiness  in  the  meatus,  inci-eascd  by  a 
pressure  on  the  external  ear,  causing  singing,  throbbing,  and 
acute  pain,  the  pulse  becoming  accelerated  with  great  restless- 
ness and  anxiety.  Should  the  affection  advance,  the  dermis 
becomes  tumefied,  so  as  to  considerably  diminish  the  calibre  of 
the  meatus;  the  pain  continues  to  increase,  and  in  a  short 
time  a  copious  discharge  suddenly  takes  place,  followed  by 
immediate  relief ;  upon  removing  the  secretion  with  a  syringe, 
the  BurfSace  of  the  tumefied  meatus  is  seen  to  be  of  a  deep  red 
colour,  and  the  epidermis  entirely  denuded,  secreting  a  muco- 
purulent fluid. 

The  treatment  in  this  stage  should  be  hot  fomentations,  or 
an  evaporating  lotion  applied  to  the  meatus  on  cotton  wool,  or 
a  poultice  with  a  few  drops  of  tincture  on  its  surface,  of  the 
same  medicine  as  prescribed  intemaUy,  but  of  a  lower  dilution, 
such  as  Aeon,  Bell.,  Puis.,  or  Mer.  v.,  and  to  syringe  the  meatus 
three  or  four  times  a  day  with  warm  water,  medicated  witli  the 
same  remedy  as  taken  internally,  so  as  to  be  absorbed  by  the 
denuded  surfaces  of  the  meatus.  Should  the  above  symptoms 
be  allowed  to  remain,  or  the  patient  not  present  himself  for 
treatment  until  the  chronic  stage  is  developed,  many  of  tlie 
important  structures  of  the  ear,  are,  to  a  certain  extent,  injured 
by  hypertrophy  of  the  dermoid  meatus,  which  causes  a  narrow- 
ing of  the  external  orifice  ;  should  the  hypertrophy  extend  to 
the  dermoid  layer  of  the  membrana  tympani,  the  power  of 
hearing  is  much  impeded,  and  very  often  lost.  Sometimes  in 
the  chronic  stage,  the  symptoms  take  on  the  catarrhal,  espe- 
cially in  those  persons  of  a  scrofulous  diathesis,  with  glan- 
dular enlargement,  and  who  are  exposed  to  a  low,  damp,  or 
moist  atmosphere. 


214     Mr.  Cutmore  on  some  Morbid  AffeetioTis  of  the  Ear. 

The  distinguishing  point  between  chronic  inflammation  and 
catarrhal,  is  the  peculiar  character  of  the  discharge  from  the 
latter  being  of  a  very  muco-purulent  form  and  of  a  very- 
offensive  kind.  When  the  disease  has  remained  some  time,  the 
mucous  membrane  of  the  tympanic  cavity  is  apt  to  be  impli- 
cated, and  deafness  of  a  more  serious  kind  is  the  result ;  how- 
ever, it  must  be  remembered,  that  catarrh  of  the  dermoid 
meatus,  and  of  the  dermoid  layer  of  the  membrana  tympani, 
frequently  is  a  symptom  of  ii^ritation  witliin  the  tympanic 
cavity,  and  the  external  symptoms  cease  so  soon  as  the  inter- 
nal irritation  is  relieved,  by  bringing  the  mucous  membranes  of 
the  throat,  tonsils,  and  eustachiah-tube  into  a  healthy  state 
with  the  remedies  I  shall  hereafter  mention. 

In  treating  chronic  diseases  of  the  ear,  and  especially  those 
which  arise  from  a  debilitated  constitution,  the  treatment  should 
be  directed  towards  reinstating  the  general  tone  of  health,  prior 
to  the  application  of  local  remedies,  which,  according  to  ex- 
perience, are  necessary  for  the  restoration  of  the  diseased 
structures.  In  chronic  discharges  of  the  ear  of  a  purulent 
kind,  I  find  that  Bell.,  Mer.  s.,  Puis.,  and  Sulph.,  to  answer  well ; 
if  of  a  syphilitic  character.  Nit.  ac.,  Mer.  rub.,  Aur.  m.,  Hep. 
Sulp. ;  and  if  caries  of  the  ossicles  and  mastoid  cells,  Aur.  mu., 
Sili.  Cal,  Assaf.  The  meatus  must  be  first  syringed  with  warm 
water,  previously  medicated  with  ten  drops  of  a  low  dilution 
of  the  remedy  as  prescribed  internally,  or  applied  to  the 
meatus  on  cotton-wool,  each  medicine  given  according  to  the 
pathogenesis  of  the  diseased  state;  in  conjunction  with  the 
above,  it  is  of  paramount  importance  to  use  every  means  to 
invigorate  the  health,  by  abundant  exercise  in  the  open  air  in 
the  country,  or  by  the  sea-side ;  sponging  the  body  daily  with 
tepid  salt  water ;  a  simple,  nutritious,  but  not  a  stimulating 
diet,  and,  above  all,  sleeping  in  a  cool,  well-ventilated  apart- 
ment, aided  by  those  Homoeopathic  remedies,  that  will  place  the 
digestive  organs  in  a  healthy  condition^  to  digest  those  aliments 
which  will  nourish  and  invigorate  the  body. 


Mr,  Outmore  on  some  Morbid  Affections  of  the  Ear.     215 

There  is  another  method  of  treatment  which  I  prefer  in 
those  cases  wliere  there  is  much  hypertrophy  of  the  dermoid 
meatus  with  large  granulated  surfaces,  which  discharge  a 
muco-puTulent  fluid,  or  a  continual  exfoliation  of  the  epidermis, 
from  chronic  congestion  of  the  dermoid  meatus;  first,  to 
syringe  the  ear  with  warm  water  in  which  a  little  carbonate  of 
soda  has  been  dissolved,  and  then  ai)ply  to  the  external  meatus 
a  solution  of  Arg.  nit.  gra.  ij,  aqute  3ij,  with  a  camel-hair  brush 
twice  a  day.  This  remedy  seems  to  act  like  a  charm,  by  re- 
lieving the  congestion  of  the  capillaries  of  the  dennoid  meatus, 
and  membrana  tympani,  especially  in  chronic  cases,  which  have 
defied  all  other  treatment. 

I  wiU  now  give  an  illustration  of  a  case  of  chronic  in- 
flammation of  the  dermoid  meatus,  with  treatment. 

Henry  CrapneU,  aged  9,  Dover,  June  5tli,  1860.  Deaf  six 
years  from  scarlatina,  previously  treated  by  several  surgeons. 
Had  a  very  offensive  discharge  from  the  right  ear  of  a  muco- 
purulent kind.  Left  ear  healthy.  Examined  the  meatus  ex- 
temus  and  syringed ;  the  dermoid  layer  of  the  meatus  being 
much  denuded  and  congested  with  granular  surfaces,  the  mem- 
brana tympani  opaque  and  soddened.  Health  good.  Hearing 
distance  of  the  right  ear,  of  the  watch,  contact.  Syringed  the 
ear  with  warm  water  in  which  a  little  soda  was  dissolved,  and  gave 
Sulp.     Prescribed  BeU.  6  gL  x.     Lotion  the  same  as  medicine. 

June  12th. — Discharge  less.  Tongue  coated.  Hearing  dis- 
tance, right  ear,  three  inches. 

Eepeat  the  medicine. 

June  18. — ^Discharge  the  same. 

Pencilled  the  meatus  with  Arg.  nit.  gr.  v.  aquas  ^ ;  Mer.  cor. 
vi.  gL  X.,  to  be  taken  internally. 

June  25. — ^Discharge  less.  Hearing  distance  of  right  ear 
seven  inches. 

Mer.  cor. 

June  2  &:— Discharge  the  same.  Hearing  distance  of  right 
ear,   eight  and  a-half  inches. 


216     Mr,  Cutmore  on  some  Morbid  Affections  of  the  Ear. 

Mer.  cor.,  with  lotion  of  ditto,  pencilled  the  meatus  extemus 
with  Arg.  nit. 

July  4. — Discharge  thick  and  more  healthy.  Hearing  dis- 
tance of  right  ear,  eleven  inches,  pencilled  the  meatus  externus, 
and  continued  the  medicine. 

July  12. — ^Discharge  nearly  ceased.  Hearing  distance  of 
right  ear,  eighteen  inches.  Applied  Arg.  nit.  to  the  surface  of 
the  meatus  extemus. 

BeU.  6  gL  x.,  with  lotion. 

July  20. — ^Discharge  the  same.  Hearing  distance  of  right 
ear  two  feet. 

Applied  Arg.  nit.  as  before.  Sulph.  6  gL  x. 

July  29. — Discharge  ceased.     Hearing  distance  of  right  ear 
three  feet.    Pencilled  the  meatus  extemus  with  Arg.  nit. 
Hep.  sulp.  6  gL  X. 

August  3. — -Cured.  Hearing  distance  of  right  ear,  three 
feet,  normal  distance. 

In  the  above  case  there  was  hypertrophy  and  congestion  of 
the  meatus  extemus,  with  discharge  of  an  obstinate  character, 
and  had  I  used  only  the  internal  remedies,  without  stimulating 
the  surfaces  of  the  meatus,  probably  it  would  have  taken  a 
much,  longer  time  to  have  eradicated. 

If  this  disease  of  the  dermoid  meatus  be  allowed  to  remain 
in  a  chronic  state  any  length  of  time,  polypi  is  generally  de- 
veloped from  the  granular  surfewes ;  sometimes,  however,  they 
arise  from  chronic  inflammation  of  the  tympanum,  or  from 
obstruction  of  the  eustachian  tube,  but  mostly  from  the  dis- 
eased surfaces  of  the  dermoid  layer,  and  at  other  times  from 
the  membrana  tympanum ;  when  the  growth  is  large,  a  sen- 
sation of  fulness  is  felt  in  the  ear,  and  not  unfrequently  a  sen- 
sation of  heaviness,  vertigo,  and  confusion  in  the  head.  These 
cerebral  symptoms  often  cause  alarm. 

The  pressure  of  the  polypus  on  the  exterior  surfaces  of  the 
membrana  tympani  and  chain  of  ossicles,  causes  tension  of  the 
fluid  in  the  vestibule. 


Mr.  Cutmcre  on  some  Morbid  Affections  of  the  Ear.     217 

There  are  two  kinds  of  polypi  The  fibro-plastic,  or  gela- 
tinoiis,  and  the  cellular^  or  vascular  polypus. 

The  fibro-plastic,  or  gelatinous  polypus,  generally  grows  from 
the  ceruminous  glands,  and  sometimes  from  other  parts  of  the 
dermoid  layer  of  the  meatus,  springing  from  a  single  root  or 
peduncle,  of  a  pale,  fleshy  colour,  insensible  to  the  touch,  and 
grows  slowly,  frequently  accompanied  by  otorrhoea,  the  discharge 
diminishing  as  the  growth  of  the  polypus  advances. 

The  treatment  is  simple,  merely  removing  it,  when  large, 
with  a  pair  of  ring  forceps,  seizing  it  as  near  to  the  root  as 
possible,  and  giving  it  a  twisting  movement ;  having  done  thus, 
means  must  be  employed  to  eradicate  its  recurrence,  which  is 
of  frequent  annoyance.  The  treatment  I  have  hitherto  used 
has  been  successful,  viz.,  pencilling  the  dermoid  meatus  daily 
with  a  solution  of  Arg.  nit.  gr.  v.  aqudB  ^  ^^^  its  removal, 
and  attending  to  the  general  health,  with  those  remedies  pre- 
viously mentioned  in  the  treatment  of  the  meatus  extemus. 

This  fibroid-pla-stic,  or  gelatinous  poljrpus,  is  generally  of  a 
purely  local  character,  merely  springing  from  the  excoriated  and 
diseased  surfaces  of  the  dermoid  meatus. 

Case  illustrating  the  fibroid-plastic  or  gelatinous  polypus, 
with  the  treatment. 

Miss  E —  B —  aged  20.  At  three  years  of  age  had  scarlet 
fever ;  since  that  time  had  a  constant  discharge  from  both  ears 
of  a  purulent  kind,  the  health  remaining  very  good ;  the  dis- 
charge was  not  particularly  noticed,  the  medical  attendant  in- 
forming the  parents  that  it  was  healthy,  and  not  to  stop  the 
dischaige  on  any  account.  At  16  years  of  age,  a  substance 
was  observed  in  the  external  meatus  of  the  left  ear ;  their  medi- 
cal man  termed  it  a  polypus,  and  removed  it  without  any  treat- 
ment In  the  course  of  a  year  another  grew,  which  was  removed 
in  the  same  way,  and  a  third,  which  was  removed  also,  besides 
several  small  ones,  which  turned  black  and  dropped  off. 

March  13th,  1861. — Came  under  treatment. 


218     Mr.  Cutmore  on  some  Morbid  Affections  of  the  Ear, 

I  observed  a  fibro-plastic  or  gelatinous  polypus,  from  the  left 
ear,  extending  outside  the  external  meatus  to  about  the  size  of 
a  walnut,  the  right  and  left  meatus  secreting  at  the  same  time 
a  muco-purulent  pus ;  the  polypus  was  insensible  to  touch,  and 
of  a  fleshy  kind.  Syringed  the  surfaces  of  both  meatus  with 
warm  water,  in  which  some  carbonate  of  soda  had  been  dis- 
solved, pencilled  the  surfaces  of  the  meatus  with  Arg.  nit.  gr.  v. 
aquse  ^  with  a  camel-hair  brush ;  hearing  distance  of  the  watch  of 
the  right  ear,  half-an-inch.  Hearing  of  left  ear  entirely  gone. 
Prescribed  Mer.  sol.  6  gL  x. 

March  14th. — ^Extracted  the  polypus  from  the  meatus,  with 
a  pair  of  ring  forceps,  giving  it  the  twisting  movement ;  much 
venous  haemorrhage  followed ;  examined  the  meatus,  and  found 
the  surfaces  very  granulated  and  tumefied,  the  membrana 
tympani  being  absorbed  and  perforated  where  the  polypus  had 
grown.  The  ossicles  intact.  Syringed  the  meatus  with  Arnica 
lotion  and  cold  water ;  directed  it  to  be  syringed  thrice  daily. 
Prescribed  BelL  6  gl.  x. 

March  15th. — Hearing  distance  of  left  ear  had  increased 
four   inches;    continued   the    syringing   with   Arnica    lotion. 
Prescribed  Am.  6  gl.  x. 

March  16th. — Hearing  distance  of  left  ear  had  increased  six 
inches,  and  discharged  a  thin  flakey  pus.     Syringed  with  warm 
water.     Pencilled  the  meatus  with  Arg.  nit. 
Prescribed  Mer.  soL  6  gl.  x. 

March  18th. — Hearing  distance  of  left  ear  the  same.  Dis- 
charge less. 

Eepeated  Arg.  nit.    Prescribed  Mer.  sol.  6  gL  x. 

March  20. — Hearing  distance  of  left  ear  seven  inches. 
Syringed  and  pencilled  with  Arg.  nit.  Bowels  constipated,  with 
pains  in  the  head. 

Prescribed  Nux.  v.  2  gL  x. 

March  22. — Hearing  distance  of  left  ear  the  same.  Still 
discharging.     Syringed  with  wann  water  and  applied  a  piece 


Mr  Cutmore  on  some  Morbid  Affections  of  the  Ear.     219 

of  cotton-wool  steeped  in  Arg.  nit.  gr.  v.  aquae  ^  to  the  orifice  of 
the  membrana  tympani,  and  allowed  it  to  remain. 
Prescribed  Sulp.  6  gl.  x. 
March  25. — Hearing  distance  of  left  ear  the  same,  right  ear 
two  inches.  Discharge  ceased  in  both  ears.  Syringed  both 
the  meatus  extemus  with  warm  water,  and  pencilled  with  Arg. 
nit.  Examined  the  meatus  with  the  speculum,  and  found  the 
membrana  tympani  hypertrophied,  concave  and  white,  and  the 
surfaces  less  vascular. 

Prescribed  Calc.  6  gl.  x. 
March  27. — Hearing  distance  of  left  ear  the  same,  right  ear 
two  and  a-half  inches.     Pencilled  both  the  meatus  with  Arg.  nit. 
Membrana  tympani  looking  healthy. 

Prescribed  Calc.  6  gl.  x. 

April  2. — Hearing  distance  of  right  and  left  ear  the  same. 

Membrana  tympani  looking  still  more  healthy.     At  church  on 

Sunday,  heard  the  preacher  for  the  first  time  since  ten  years. 

Prescribed  Mer.  soL  6  gl.  x. 

April  5. — ^The  same. 

Cal.  6  gL  X. 
April  10. — ^The  same. 

Prescribed  Sulp.  6  gl.  x. 
April  1 5. — Hearing  distance  of  left  ear  the  same ;  both  the 
extemus   meatus   and   membrana   tympani    looking   healthy. 
Applied  an  artificial  tympanum  to  the  left  ear. 
Prescribed  Sac.  lac. 
April  18. — Hearing  distance  of  left  ear  much  improved  with 
the  artificial  tympanum.     Hearing  distance  of  right  ear  five 
inches.     Left :  The  hearing  restored  so  far  as  the  disorganiza- 
tion of  the  ear  would  permit,  and  no  recurrence  of  tumours. 
The  Cellular  or  Vascular  Polypus. 
This  afiection  is  of  a  fungoid  or  cancerous  growth,  and  arises 
firom  a  low  cachectic  state  of  the  constitution,  poisoned  either 
by  scarlatina,  measles,  or  some  exhaustive  disease.     It  consists 
of  vascular  granulations,  growing  frequently  with  a  broad  base 


220      Mr,  Cuimore  on  some  morbid  Affections  of  the  Ear. 

from  the  membrana  tympani,  or  dermoid  layer  of  the  meatus, 
of  a  red,  raspberry  hue,  extremely  sensitive,  bleeds  on  the 
slightest  touch,  owing  to  its  great  vascularity,  and  grows 
rapidly,  often  discharging  a  foetid  kind  of  pus.  The  treatment 
of  this  kind  of  polypus  is  somewhat  different  to  the  former,  if 
large,  and  causing  cerebral  disturbance,  it  must  be  removed 
with  the  ring  forceps,  and  the  constitution  reinstated  by  reme- 
dies, suited,  according  to  the  peculiar  dyscrasia  of  the  patient. 

The  following  medicines  may  be  consulted  with  great  ad- 
vantage in  this  class  of  polypus,  arising,  as  it  generally  does, 
from  a  low  state  of  the  constitution ; — Sulp.,  CaL,  Mer.  s.,  Mer. 
ru.,  Ars.,  Nit.  acL,  Phos.,  Sepia.,  SiL,  Hep.,  Staph.,  Lach.,  Rhus- 
tox.,  Aci.  sulp. 

The  meatus  must  be  syringed  twice  a  day  with  warm  water, 
containing  a  few  drops  of  the  Ist  or  2nd  dilution  of  the  indi- 
catiQg  internal  remedy. 

I  have  generally  used  from  the  6th,  12  th,  and  30th  dilution 
in  tinctures. 

When  the  discharge  is  of  a  foetid  kind,  no  application  is 
better  adapted  than  an  injection  of  Chlorate  of  Potash,  gr.  xx 
Aqu,  5  X.,  syringing  once  or  twice  a  day  as  the  case  may  re- 
quire. If  the  granulations  are  large  and  flabby,  syringe  the 
meatus  with  Nit.  aci  3  ij-  ^  ^  half-pint  of  water,  or  if  pre- 
ferred, a  calendula  lotion,  3  iij.  ad  ^  ij.  is  a  very  good  injection. 

Exostosis. 

Exostosis,  or  osseous  tumours,  of  the  meatus  externus,  is  a 
disease  which  frequently  occurs  in  the  middle  period  of  life  to 
those  persons  of  a  rheumatic  or  arthritic  diathesis,  or  those  who 
may  be  termed  free  livers,  taking  much  stimulating  food. 

The  development  of  the  tumour  is  slow,  and  frequently  un- 
attended with  any  symptoms  calculated  to  attract  the  attention 
of  the  patient.  When  from  a  cold,  or  a  sudden  change  in  the 
weather,  causing  an  accumulation  of  cerumen  in  the  meatus,  the 
aperture  becomes  closed,  deafness  is  complained  of,  and  relief  is 
sought;  sometimes  the  growth  of  the  tumour  produces  a  feeliiig 


Mr,  Cutmore  on  some  Morbid  Aj^ectians  of  the  Ear.     221 

of  distencdon  in  the  ear,  and  a  weight  in  the  side  affected.  The 
semiology  of  the  disease  may  be  confounded  with  polypus,  or 
hypertrophy  of  the  dermoid  meatus,  but  on  an  inspection  with 
the  speculum,  it  soon  disappears,  for  the  polypus  is  of  a  dark 
colour,  and  moistened  with  a  discharge,  very  often  of  a  foetid 
kind,  whereas,  the  osseous  tumour  is  white,  hard,  and  dry ;  how- 
ever, should  there  be  any  doubt,  it  would  be  removed  by  the 
use  of  the  probe.  Very  frequently  there  is  a  collection  of  hypertro- 
phied  epidermis,  and  on  relieving  the  meatus  of  this  the  hearing 
is  much  improved.  The  osseous  growth  is  affected  by  the 
application  of  the  Tincture  of  Iodine  on  a  camel-hair  brush  to 
the  internal  surface  of  the  meatus  extemus;  also,  I  have  found 
great  assistance  in  this  affection  of  the  ear,  from  passing  a  con- 
tinuous current  of  galvanism  through  the  tumour  to  cause  its 
absorption,  and  attending  to  the  rheumatic  and  gouty  dia- 
thesis by  internal  remedies,  such  as  Caust.,  CaL,  SiL,  Ant.  cm., 
Clem.,  Aur.  m.,  Phos.,  Ass.,  Euta.,  Kali,  bi.  Hep.,  Sulp.,  lod., 
Colo.,  Cocc,  Ehodo.,  in  dilutions  varying  according  to  the  tem- 
perament and  peculiarities  of  the  patient,  from  the  3rd,  6th,  to 
the  30th  dilution. 

Membrana  Tympaot. 

We  now  come  to  another  structure  in  the  ear,  which  is  im- 
portant to  keep  in  a  healthy  condition,  and  to  restore  when  it 
becomes  altered  by  disease,  viz.,  the  membrana  tympani  I  will, 
en  passant  describe  the  different  layers  of  that  membrane,  in  order 
to  facilitate  the  diagnosis  of  various  alterations  which  take 
place  in  that  important  membrane,  as  they  give  rise  to  many 
difi&culties  in  the  treatment  of  deafuess. 

The  membrana  tympani  is  composed  of  four  layers,  viz. : — 
epidermic,  dermoid,  fibroid  layer,  and  mucous. 

The  fibroid  layer  is  composed  of  two  laminas,  one  of  radiating, 
and  the  other  of  circular  fibres,  which  are  attached  to  the  pro- 
cessus longus  of  the  malleus,  keeping  tense  the  membrana  tym- 
pani with  the  aid  of  the  ligament  of  the  tensor  tympani  muscle, 
necessary  for  the  acute  state  of  hearing ;  the  mucus  layer  lines 


222     Mr.  Cutmore  on  some  Morbid  Affections  of  the  Ear. 

the  tympanic  cavity  and  covers  the  whole.  The  various  diseases 
which  attack  the  membrana  tympani  are  acute  and  chronic  in- 
flammation, the  latter  running  into  catarrh  and  ulceration,  hy- 
pertrophy, relaxation  and  perforation. 

The  four  first  of  the  diseases  above-mentioned,  have  been 
spoken  of  separately  with  their  treatment,  in  the  dermoid  layer 
of  the  meatus  extemus,  the  dermoid  layer  of  the  membrana 
tympani  being  continuous  with  that  membrane. 

Hypertrophy  of  the  membrana  tympani  considerably  interferes 
with  the  usefulness  of  the  organ  of  hearing,  by  destroying  its 
elasticity  and  impeding  the  sonorous  undulations  from  passing 
through  to  the  vestibule,  therefore,  it  behoves  the  surgeon  to 
use  those  means  and  remedies  that  will  alter  and  avert  such 
consequences,  and  to  keep  the  membrana  tympani  in  a  healthy 
state.  The  best  means  that  I  can  at  present  deduce  from  my 
experience,  is  to  pencil  the  membrana  tympani  with  Arg.  nit. 
3  gs.  aquae  ^  L  with  a  camel-hair  brush  twice  a  week,  with  the 
proviso  that  there  is  not  any  abrasion,  previously  syringing  the 
meatus  with  warm  water,  also,  by  the  application  of  a  most 
useful  therapeutic  agent  for  the  absorption  of  fluid  and  hyper- 
trophy, viz.,  galvanism ;  I  generally  place  the  positive  pole  on 
the  upper  part  of  the  cervical  vertebrae,  and  the  negative  pole 
over  the  mastoid  process,  and  sometimes  introduce  it  into  the 
external  meatus,  stimulating  the  membrani  tympani,  eustachian 
tube  and  the  contents  of  the  labjTinth. 

Eelaxation  of  the  Membrana  Tympaih. 

This  disease  is  a  frequent  cause  of  deafness  in  debilitated 
and  scrofulous  constitutions,  also  in  those  persons  who  sufier 
from  chronic  catarrh  of  the  nasal  passages,  the  mucous  mem- 
bane  being  in  connexion  with  the  fauces,  is  generally  in  a  re- 
laxed state  also. 

Upon  examination,  the  membrana  tympani  will  generally 
be  found  opaque,  concave,  and  frequently  hypertrophied,  the 
bright  spot  elongated,  and  the  manubrium  of  the  malleus 
standing  out  prominently. 


Mr.  Cutmore  on  some  Morbid  Affections  of  the  Ear.     223 

The  result  of  these  objective  symptoms  is  deficiency  of  hear- 
ing, with  a  sensation  of  fullness  in  the  head,  and  a  feeling  as . 
if  one  spoke  thickly. 

The  diagnosis  of  this  disease  is  not  at  all  difficult ;  by 
directing  the  patient  to  hold  his  nose  while  inhaUng  his  breath* 
and  to  forcibly  expire  with  the  closed  mouth,  so  as  to  force  the 
air  through  the  eustachian  tube,  will  cause  the  membrana 
tympani  to  become  tense  and  natural,  and  produce  an  ameliora- 
tion of  all  unpleasant  symptoms.  In  this  aflfection  the  remedies 
are  mostly  of  a  constitutional  kind ;  where  permanent  benefit 
is  derived  from  attending  to  the  general  tone  of  health,  as 
already  observed,  in  treating  chronic  diseases  of  the  external 
meatus,  with  those  medicines  which  have  a  long  range  of  action 
on  the  system  and  mucous  surfaces.  Dul.,  Puis.,  Carb.,  Nux.  v., 
LacL,  Cal,  Sili.,  Mer.  s.,  Sulp.  If  much  hypertrophy  of  the 
membrana  tympani,  the  use  of  the  Arg.  nit.,  as  before-mentioned 
will  be  of  use,  in  thinning  and  toning  the  fibres,  aided  by 
galvanism,  if  obstinate. 

Perforation. 

The  next  aflfection  of  the  membrana  tympani  that  I  shall 
allude  to  will  be  perforation.  The  usual  cause  of  perforation 
of  the  membrana  tympani,  is  catarrh  of  the  mucous  mem- 
brane of  the  tympanic  cavity,  and  not  the  result  of  ulceration, 
as  is  generally  supposed,  but  from  that  membrane  secreting 
too  abundantly,  and  the  natural  orifice  of  the  eustachian  tube 
being  nearly  closed  by  viscid  mucus,  is  unable  to  carry  it 
away  through  the  fauces,  and  the  absorption  of  the  membrana 
tympani,  is  the  result  of  the  pressure  of  the  viscid  mucous 
inside  the  tympanic  cavity ;  it  generally  arises  from  scarlatina, 
measles,  or  chronic  catarrh  of  the  fauces. 

Perforation  of  the  membrana  tympani  is  not  always  attended 
with  total  loss  of  hearing,  except  when  there  is  much  hyper- 
trophy, or  relaxation  of  that  membrane,  when  the  power  of 
hearing  becomes  greatly  diminished.  The  treatment  is  simple. 
Bedace  the  hypertrophy  by  applying  Arg.  nit.,  similar  to  that 


224     Mr,  Cuimore  on  some  Morbid  Affections  of  the  Ear. 

spoken  of  in  hypertrophy  of  the  external  meatus.  When  the 
membrane  becomes  more  healthy,  apply  a  piece  of  moist  cotton- 
wool to  the  orifice,  by  means  of  the  speculum,  and  with  a  pair 
of  fine  plyers,  or  an  artificial  membrana  tympani  made  of 
India-rubber,  so  as  to  confine  the  vibrations  of  the  air  in  the 
tympanic  cavity,  and  to  concentrate  it  on  the  labyrintL  The 
diagnosis  of  this  affection  is  easy;  desire  the  patient  to  hold 
his  nose,  and  blow  with  his  mouth  closed,  if  the  membrana 
tympani  is  not  pervious,  you  will  audibly  hear  an  escape 
of  air  making  a  hissing  noise  through  the  external  meatus,  or 
upon  examining  the  ear  with  a  speculum  during  his  blowing, 
you  will  perceive  the  edges  of  the  opening  expand. 

The  Eustachian  Tubk 

This  is  another  important  structure  connected  with  the 
organ  of  hearing,  and  should  there  be  any  alteration  from  its 
natural  state,  deafness  ensues ;  it  is  frequently  over-looked  by 
surgeons  when  searching  for  the  cause  of  deafness,  thinking 
that  the  meatus  and  membrana  tympani,  ought  only  to  be  the 
objects  of  their  attention. 

The  especial  use  of  the  eustachian  tube  when  in  a  healthy 
state,  is  to  allow  ingress  of  air  to  the  tympanic  cavity,  and 
egress  of  mucus  from  it ;  when  mucus  is  too  abundantly  secreted, 
these  natural  functions  are  impeded,  either  from  hypertrophy, 
congestion  of  the  mucous  membrane  of  the  tube,  or  closed  by  an 
abnormal  quantity  of  mucous,  so  that  deafness  ensues;  there- 
fore it  is  necessary  that  the  canal  should  be  kept  pervious,  and 
a  constant  interchange  of  air  in  the  cavity  of  the  tympanum. 

The  frequent  cause  of  obstruction  of  the  ^eustachian  tube 
arises  then  from  chronic  congestion,  and  hypertrophy  of  its 
mucous  membrane  at  the  faucial  orifice,  and  sometimes  from 
an  accumulation  of  secretion  from  its  lining  membrane  of  the 
t3rmpanic  cavity;  it  generally  arises  from  chronic  catarrh  of 
the  nasal  passages  and  fauces,  with  enlargement  of  the  tonsils, 
occuring  in  persons  of  a  scrofulous  diathesis. 


Mr.  Cutmore  on  some  Morbid  Affections  of  the  Ear.     225 

This  kind  of  deafness  usually  happens  suddenly,  upon  taking 
cold  or  an  exposure  to  the  night  air,  and  very  often  disappears 
as  suddenly,  with  a  loud  crack  in  the  ears,  and  an  improve- 
ment of  the  hearing,  which  is  of  short  duration. 

Upon  examining  the  membrana  tympani  with  a  speculum,  it 
will  be  seen  to  be  very  concave  and  opaque,  frequently  drawn 
inwards,  so  as  to  approach  the  stapes ;  the  concavity  of  the 
membrana  tympani  is  often  a  diagnostic  sign  of  the  eustachian 
tube  being  impervious,  arising  either  from  chronic  congestion, 
hypertrophy,  or  an  accumulation  of  viscid  mucus,  but  the  true 
method  of  ascertaining  the  state  of  the  eustachian  tube  is  by 
the  otoscope,  an  instrument  of  great  value  in  diagnosing 
diseases  of  the  ear;  this  instrument  is  an  elastic  tube,  about 
eighteen  inches  in  length,  and  each  end  tipped  with  ebony,  one 
end  is  inserted  into  the  ear  of  the  surgeon,  and  the  other  end 
into  that  of  the  patient,  who  must  swallow  a  little  saliva,  his 
nose  and  mouth  being  closed ;  if  then  the  eustachian  tube  be 
pervious,  at  the  moment  of  swallowing  he  will  feel  a  sensation 
of  fulness  in  the  ears,  and  the  surgeon  will  hear  distinctly  a 
crackling  sound  produced  by  a  slight  movement  of  the  mem- 
brana tympani  outwards ;  if  the  crackling  is  not  heard,  however 
faint,  there  is  certain  to  be  an  obstruction  of  the  eustachian 
tube,  especially  if  the  membrana  tympani  is  concave. 

In  treating  of  these  diseases  of  the  eustachian  tube  and 
fences,  I  may  state  that  they  principally  arise  from  a  cachectic 
state  of  the  constitution,  brought  into  activity  by  scarlatina^ 
measles,  residing  in  a  damp  locality,  or  exposure  to  a  cold;  moist, 
atmosphere;  such  causes  must  be  removed,  and  the' patient 
placed  in  as  favourable  a  position  as  possible  for  recovery; 
also  hygienic  means  must  be  resorted  to  as  mentioned  in  the 
treatment  for  chronic  inflanmiation  of  the  meatus,  with  the 
following  addition:  a  cold  compress  placed  around  the  throat  and 
neck  on  going  to  bed,  and  in  the  morning  to  bathe  the  throat  and 
neck  with  cold  salt  water,  and  rub  it  afterwards  with  a  coarse 
towel  until  a  glow  is  produced,  adding  the  administration  of  some 

VOL.  in.  15 


226      Mr,  Cuimore  on  some  Morbid  Affections  of  the  Ear, 

of  the  following  medicines — I  have  generally  found  them 
Homoeopathic  to  the  subjective  symptoms  of  the  diseases  which 
attack  the  eustachian  tube  and  throat,  each  medicine  prescribed 
according  to  its  correspondence  with  the  diseased  state  of  the 
patient — ^Ammon.  caust.,  Calc,  lodi.,  Merc,  ioda.,  Mer.  s..  Nit. 
acid,  Kal.  car.,  Kali,  hydriodi.  Con.,  Kreas.,  Lach.,  Phos.,  Grap. 
Caust.,  Nat.  mur..  Puis.,  Sili.,  Dulc, 

DISCUSSION. 

Db.  Djrury,  while  thanking  the  author  for  his  paper,  felt  that 
the  thanks  of  the  Society  were  also  due  to  Mr.  Cameron,  for  the 
excellent  manner  in  which  he  had  read  it :  good  reading  always 
helping  to  place  an  author  on  better  terms  with  his  audience. 
It  was  to  be  regretted  that  Homoepathic  literature  was  deficient 
in  diseases  of  the  ear,  and  he.  Dr.  Drury,  was  glad  to  find 
that  Mr.  Cutmore  was  giving  his  attention  to  this  matter,  as  it 
was  always  desirable  that  specialities  should  be  in  the  hands  of 
respectable  practitioners.  Though  some  able  and  upright  men 
amoDgst  the  Allopaths  had  selected  this  department  for  their 
particular  attention,  there  was  no  doubt  that  aural  surgery  had 
not  been  as  well  represented  as  it  might  in  the  profession,  so  that 
is  required  all  the  weight  of  a  Toynbee  or  a  Harvey  to  raise  it 
again  in  public  estimation.  When  such  stories  were  current  as 
that  of  "  the  watch  trick,"  it  was  most  desirable  to  see  men  of 
standing  trustiug  to  their  own  skill  and  integrity  to  raise  them 
above  any  such  suspicion.  What  he  spoke  of  as  the  watch  trick, 
was  simply  the  using  a  loud  ticking  stop  watch,  by  which  the 
first  day,  as  close  to  the  ear  as  possible  nothing  could  be  heard, 
while  on  the  second  visit,  the  loud  tick  showed  the  patient  how 
much  he  had  improved.  Knavery  of  this  sort  had  possibly 
frightened  some  men  from  being  associated  in  the  same  depart- 
ment with  such  charlatans.  Mr.  Cutmore's  paper  was  very  in- 
teresting and  gave  some  valuable  information.  It  was  much  to  be 
regrettecf  that  Mr.  Cutmore  had  not  given  the  indications  for  the 
medicines,  or  that  he  had  not  trusted  more  to  them  and  less 
to  what  might  be  termed  Allopathic  auxiliaries.  If  in  remo- 
delling his  paper  he  would  rectify  this  error  and  give  his  reasons 
for  using  certain  drugs,  and  the  effects  that  he  could  fairly  trace 
to  them,  it  would  much  enhance  its  value. 

Mr.  Yeldham  said  Mr.  Cutmore  had  adhered  rather  loosely 
to  the  title  of  his  paper,  inasmuch  as  the  most  important  and  in- 
teresting of  all  the  affections  of  the  ear,  viz.,  deafness  arising 


Mr,  Cutmore  on  some  Morbid  Affections  of  the  Ear.     227 

from  disease  of  the  auditory  nerve,  were  scarcely  alluded  to.   He 
certainly  did  expect  that  in  a  paper  of  so  comprehensive  a  title,* 
these  cases  would  not  have  been  omitted.    Mr.  Cutmore's  paper 
was  interesting  as  far  as  it  went,  in  the  description  of  ordinaiy 
affections  of  the  external  ear  and  passages.    Mr.  Outmore's 
treatment  of  these  he  thought  was  somewhat  meagre,  and  by  no 
means  noveL     The  accumulation  of  hardened  wax  in  the  ear 
was  a  fertile  source  of  temporary  deafness.     He,  Mr.  Yeldham, 
was  constantly  meeting  with  cases  in  which  relief  was  afforded 
in  a  few  minutes  by  carefully  syringing  the  ear.    This  operation 
must  be  done  thoroughly  to  be  effectual,  and  even  then  in  some 
cases  it  failed  to  remove  the  obstruction.     Some  time  ago,  a 
gentleman  came  to  him  for  deafness  which  had  existed  in  one 
ear  for  years,  and  which  had  been  ineffectually  treated.     On 
examining  the  ear,   he,    Mr.  Yeldham,  was    satisfied  that  it 
arose  from    mechanical    obstruction.      The  syringe  failed  to 
remove  it.     He  then  introduced  a  fine  hooked  instrument,  like 
a  crochet  needle,  and  extracted  a  hard  substance  like  a  bullet. 
The   cure  was,  of  course,  instantaneous.      The   patient   then 
recollected  that  two  years  before  he  had  introduced  a  piece 
of  paper  into  his  ear,  which  he  had  never  removed,  and  this 
formed  the  nucleus  around  which  the  wax  had  hardened.    Mr. 
Cutmore's  description  of  inflammation  of  the  meatus  audetorus 
extemus  did  not  appear  to  be  very  distinct.     He,  Mr.  Yeldham, 
had  not  often  met  with  it  excepting  in  young  scrofulous  subjects, 
being  either  idiopathic,  or  the  result  of  scarlatina,  and  the  best 
remedies  were  those  which  best  combated  the  scrofulous  diathesis 
— Calcar,  Hepar,  Sulph.,  Pulsatilla,  Phosphorus,  and  cod  liver 
oil — a  weak  Arnica-lotion  he  had  found  to  be  the  best  local  ap- 
plication.    Mr.  Cutmore  had  omitted  to  mention  a  very  fertile 
source  of  obstructed  hearing,  viz.,  eczema  of  the  external  ear  and 
passage.   This  disease,  which  often  attacked  those  parts,  thickened 
the  Iming  membranes,  and  caused,  sometimes  permanently,  an 
almost  complete  occlusion  of  the  external  canaL     Mr.  Cutmore 
had  spoken  of  osseous  tumour  and  of  polypus  as  frequent 
diseases.     In  his,  Mr.  Yeldham's,  experience,  they  were  by  no 
means  common.     He  had  seen  only  one  case  of  polypus  for  some 
years  past,  and  hardly  recollected  a  case  of  deafness  from  osseous 
tumour.    The  passing  into  the  eustachean  tube  of  the  catheter, 
which  required  some  dexterity,  was,  in  some  cases,  doubtless, 
a  useful  operation,  as  it  is  performed  by  aurists.      His  old 
friend,  the  late  Mr.  Pelcher,  had  passed  it  for  him,  Mr.  Yeldham, 
many  years  ago,  for  deafness,  and  afforded  relief  for  a  few  hours 
by  expelling  a  globule  of  air ;  but  the  relief  was  very  transitory. 

*  The  original  title  was  more  ambitious  than  the  present  one. 

15* 


228  A  Case  of  Hcematuria  and 

The  deafness  returned  and  remained  for  months,  imtil  one  day, 
whilst  he  was  ascending  a  high  hill,  it  went  off  with  a  loud  bang, 
and  never  returned.  He,  Mr.  Yeldham,  did  not  agree  with  one 
of  the  speakers  who  had  preceded  him  in  recommending  Mr. 
Cutmore  to  make  diseases  of  the  ear  a  "  speciality."  He  believed 
these  diseases  were  well  understood  by  most  medical  men,  besides 
which  the  Homeopathic  body  was  at  present  too  small  to  admit, 
without  disadvantage,  of  being  cut  up  into  specialities. 

Mr.  Cameron. — ^I  cannot  agree  with  the  objections  which  have 
been  so  generally  made  this  evening  against  the  preponderating 
importance  which  Mr.  Cutmore  has  given  to  the  surgical  over 
the  Homoeopathic  treatment  of  diseases  of  the  ear,  for  I  believe 
that  in  this  class  of  ailments,  purely  medical  treatment,  whether 
Allopathic  or  Homoeopathic,  is  seldom  of  much  direct  use.  When 
the  aurist  has  directed  his  attention  to  the  improvement  of  the 
general  health  of  his  patient,  or,  in  cases  of  acute  pain,  admi- 
nistered his  sedative ;  or  attacked,  upon  general  principles,  rheu- 
matic or  gouty  inflammation  among  the  small  bones  of  the  internal 
ear,  or  their  articulations,  he  has  pretty  well  exhausted  hisresources 
of  a  purely  medical  kind.  The  surgical  treatment  of  the  ear,  if  often 
not  more  successful,  is  at  least  not  so  limited  in  its  applications,  and 
I  think  Mr.  Cutmore  had  no  choice  left  him  in  his  endeavour  to 
present  us  with  a  comprehensive  view  of  the  diseases  of  the  ear 
and  their  treatment,  but  draw  our  chief  attention  to  their  surgery. 
I  am  afraid,  however,  that  even  this  is  not  a  very  successful  field 
of  practice,  and  that  patients,  from  sad  experience,  have  made 
up  their  minds  to  be  satisfied  with  a  "  safe  **  aurist,  without  ex- 
pecting any  great  things  from  him  in  the  way  of  cure  in  very 
many  cases.  I  had  ample  opportunities  two  years  ago,  of  wit- 
nessing the  practice  of  Dr.  Kramer,  of  Berlin,  perhaps  the  most 
eminent  aurist  in  Europe,  and  was  then  painfully  impressed  with 
the  slender  modicum  of  success  which  attended  his  skilful 
attempts  to  relieve  the  patients  whom  I  had  persuaded  to 
consult  him. 


A  CASE  OF  HiEMATUEIA  AND  ALBUMINURIA  AFTER 
SCARLATINA  MILLARIA. 

By  Dr.  Thinks,  Corresponding  Member  of  the  Society. 

[From  the  Neue  Zeitschrifb  der  Homoeopathischen  Kilimk.] 

Antoine  de  S os,  aged  15,  of  a  feeble  and  strongly  de- 
veloped scrofulous   constitution,  of  high  mental  endowments 


AUmminuria  after  Scarlatina  Miliaria,  229 

and  a  nervous  temperament,  had  suffered  from  many  serious 
attacks  of  disease  at  different  periods  of  his  life.  In  his  tenth 
year  he  had  inflammation  of  the  whole  of  the  right  lung,  which, 
never  being  entirely  cured,  left  it  in  a  state  of  camification  as  high 
as  the  fourth  rib,  and  it  was  only  above  this  point  that  the  respira- 
tory murmur  was  audible.  Two  years  later  he  suffered  from  abdo- 
minal typhus,  which,  according  to  the  statement  of  his  mother, 
who  was  minutely  informed  of  the  facts  by  the  physicians  of 
Warschau  who  were  in  attendance,  induced  an  attack  of  albu- 
minuria. In  the  preceding  autumn  he  had  caught  cold  and  was 
laid  up  by  a  laryngeal  and  bronchial  catarrh,  which  was  cured 
by  a  course  of  the  Kieselbrunnen  of  Ems. 

He  passed  the  comparatively  mild  winter  of  1862-68  in 
perfect  bodily  comfort,  till  the  25th  of  February,  when  he  was 
suddenly  seized  with  headache,  vomiting,  and  slight  sore  throat. 
Having  then  been  called  in,  I  prepared  his  parents  for  the  appear- 
ance of  scarlet  fever,  as  I  had  seen  the  same  premonitory  symptoms 
in  many  children;  and  so  it  proved  to  be,  for  the  eruption  showed 
itself  the  following  night.  The  scarlet  fever  ran  a  very  mild 
course,  there  was  very  moderate  fever  from  first  to  last ;  the 
sore  throat  was  but  slight  likewise  during  the  first  three  days ; 
there  occurred,  however,  a  most  unpleasant  nervous  restlessness, 
which  lasted  day  and  night,  making  sleep  impossible,  and  causing 
lively  images  and  slight  delirium  for  the  two  first  days.  The 
rash  was  not  much  developed,  it  spread  as  a  miliary  eruption 
from  the  upper  to  the  lower  portions  of  the  body,  excited  un- 
pleasant itching,  paled  as  early  as  the  fourth  day,  and  at  the 
same  time  the  sore  throat  disappeared,  and  the  fever  from  this 
time  rapidly  diminished. 

Under  the  administration  of  Aconite  in  the  2nd  decimal  dilu- 
tion, at  the  rate  of  three  drops  every  three  hours  in  water,  and 
a  couple  of  doses  of  three  drops  of  coffea,  1st  dilution,  to  allay 
the  nervous  restlessness,  the  scarlet  fever  ran  its  course  without 
any  further  remarkable  symptom.  The  exfoliation  of  the  cuticle 
began  upon  the  face  and  neck  on  the  seventh  day,  and  somewhat 


230  A  Case  of  Hcematuria  and 

later  on  the  other  parts  of  the  body.  On  the  tenth  day,  on 
account  of  the  increased  appetite  of  the  patient,  he  was 
allowed  meat  and  broth,  and  all  his  functions  were  performed 
with  perfect  regularity.  He  was  kept  in  bed  and  felt  perfectly 
well  until  the  sixteenth  day,  on  the  early  morning  of  which  his 
mother  observed  swelling  of  the  face  and  of  both  hands,  and 
showed  me  on  my  visit  that  there  was  albumen  in  the  urine, 
for  before  1  got  to  the  house,  indeed  whenever  she  noticed 
the  swelling,  she  had  boiled  some  of  the  water,  and  the  amount 
of  the  albumen  was  very  considerable.  The  urine  reddened 
litmus  paper.  Taught  by  former  experience,  I  was  in  no  hurry 
in  prescribing  a  medicine,  for  I  had  frequently  observed  that 
blood  appeared  after  the  administration  of  HeUeborous  niger.  I 
had  formerly  ascribed  this  appearance  to  the  t/OO  powerful  action 
of  this  remedy,  and  I  wished  to  observe  whether  the  same 
symptom  would  appear  without  the  use  of  any  medicine  what- 
ever. The  result  justified  my  suspicions,  for  next  day  I  found 
blood  in  the  urine,  and  this  rapidly  increased  in  quantity  during 
the  following  days  without  the  use  of  any  medicine ;  so  that 
the  whole  urine,  which  was  not  inconsiderable  in  quantity,  was 
of  quite  a  blood-red  appearance.  There  was  no  increase  of 
thirst.  The  secretion  of  urine  in  respect  to  its  amount  seemed 
at  the  same  time  much  increased ;  it  also  showed  the  same  con- 
siderable quantity  of  albumen  when  being  boiled.  The  swel- 
ling of  the  face  and  hands  did  not  increase,  and  this  anasarca 
did  not  extend  itself  to  other  parts  of  the  body,  as  rapidly  hap- 
pens in  cases  of  this  description. 

Looking  upon  this  hsematuria  as  an  active  hypersemia  of  the 
kidneys  I  did  not  wish  to  take  energetic  measures  to  subdue  it. 
However,  the  marked  retardation  and  compressability  of  the 
pulse,  the  increased  feebleness  of  the  action  of  the  heart,  the 
anaemic  murmur  in  the  ventricles,  the  paleness  of  the  face  and 
lips  of  the  gums  and  tongue,  informed  me  that  a  state  of 
anaemia  was  being  established,  notwithstanding  that  the  appetite 
continued  good  and  that  the  digestive  functions  including  defe- 


Albuminuria  after  Scarlatina  Miliaria.  231 

cation  went  on  with  regularity.  Sleep,  too,  remained  undisturbed, 
althougli  the  patient  was  not  strengthened  by  it. 

On  the  6th  day  of  the  attack  the  urine  contained  a  very 
large  quantity  of  blood,  which  fell  to  the  bottom  of  the  vessel, 
and  also  a  large  quantity  of  albumen ;  it  had  lost  all  the  proper 
urinous  smell,  and  was  passed  in  considerable  quantity,  the 
oedema  of  the  face  and  hands  was  gone,  but  the  other  symptoms 
continued  to  run  their  own  course.  Having  in  view  chiefly 
the  necessity  of  arresting  the  progress  of  the  anaemia  and 
nephritic  haemorrhage,  I  ordered  the  patient  3  drops  of  the  1st 
decimal  dilution  of  China  every  four  hours,  and  to  take  a 
nourishing  but  at  the  same  time  easily  digested  diet,  consisting 
of  slightly  roasted  white  meat  and  broth. 

In  two  days  after  the  administration  of  the  China,  the 
quantity  of  albumen  in  the  urine  decreased,  and  this  diminution 
continued  to  advance  each  day,  while  on  the  other  hand  the 
quantity  of  blood  in  the  urine  was  only  slightly  affected,  and 
it  was  not  till  after  the  albumen  had  entirely  disappeared,  and 
the  quantity  of  the  urine  had  sensibly  lessened,  that  the  blood 
very  gradually  and  slowly  disappeared.  After  the  entire  dis- 
appearance of  the  blood,  the  urine  passed  during  the  night  de- 
posited a  large  quantity  of  reddish  crystals,  which  were 
recognised  as  those  of  cystecin  when  viewed  under  the  micro- 
scope. After  a  few  days,  they,  too,  entirely  disappeared,  and 
the  patient  rapidly  advanced  to  a  perfect  sense  of  health  both 
of  body  and  mind. 

China  in  this  case  first  cured  the  albuminuria  within  a  few 
days,  then  the  nephritic  haemorrhage,  and  then  the  anaemia  this 
occasioned.  The  further  development  of  the  general  dropsy  was 
visibly  checked  likewise  by  this  remedy,  so  that  the  organism 
was  spared  the  effect  of  absorbing  the  serous  effusion  in  the 
subcutaneous  cellular  tissue.  Should  other  practitioners  find 
China  of  use  in  similar  cases,  the  sphere  of  action  of  this 
remedy,  otherwise  so  valuable,  will  have  received  an  important 
eztention. 


232  A  Case  of  HcematvHa  and 

In  severe  cases  of  scarlet  fever,  I  have  always  found  that  the 
kidneys,  as  well  as  the  brain,  were  affected  from  the  beginning, 
although  sometimes  in  a  slight,  at  other  times  in  a  severe 
degree.  Either  diabetes  insipidus  without  any  albumen  oc- 
curred, or  the  opposite  condition  was  present,  and  along  with  a 
diminished  secretion,  the  urine,  on  being  boiled,  exhibited  traces 
of  albumen.  This  particular  direction  of  the  scarlet  fever  poison 
towards  the  kidneys  explains  the  frequent  appearance  of  albu- 
minuria and  hsematuria  as  consequences  of  an  attack  of  scarlet 
fever,  both  of  these  affections  being  uncommon  in  other  exan- 
themata. Neither  errors  of  diet  nor  exposure  to  cold  give  rise 
nor  are  the  cause  of  this  albuminuria,  but  the  chief  cause  is  this 
sole  and  only  one,  that  the  scarlet  fever  poison  has  not  been 
fully  eliminated  from  the  system,  and  this  it  is  that  produces 
this  peculiar  affection  of  the  kidneys  in  such  cases.  It  is 
chiefly  in  persons  of  a  highly-scrofulous  constitution  in  whom 
this  sequela  occurs  during  the  process  of  desquamation. 

In  the  case  just  related  I  was  induced  to  prescribe  China  on 
account  of  the  rapid  development  of  the  anaemia,  also  from  the 
character  of  the  haemorrhage,  for  I  had  not  before  observed  that 
this  medicine  exerted  so  decided  an  action  in  checking  albu- 
minous urine.  The  result  was  the  more  surprising  to  me,  as  I 
had  not  found  the  least  diminution  in  the  quantity  of  albumen 
produced  by  the  administration  for  a  long  time  of  the  Sulphate 
of  quinine  in  the  instance  of  a  patient  of  sixty  years  of  age, 
whose  case  was  one  of  idiopathic  albuminuria.  In  cases  of 
simple  albuminuria  after  scarlet  fever,  with  serous  infiltration 
of  the  subcutaneous  cellular  tissue  of  the  face,  the  limbs  and 
the  whole  body,  but  without  consentaneous  hsematuria,  Helle- 
borus  niger  has  always  proved  suflBicient,  and  I  never  have  had 
occasion  to  employ  Arsenicum ;  the  Hellebore  alone  has  always 
sufficed  to  cure  the  affection. 

As  the  therapeutics  of  scarlet  fever  gradually  becomes  more 
and  more  perfect,  both  in  reference  to  the  treatment  of  the 
disease  itself  and  of  its  complications  and  consequences,  we  may 


A  Case  of  Paratyphlitis,  233 

indulge  the  hope  that  in  the  course  of  time  we  shall  discover 
the  appropriate  remedies  for  the  cerebral  aflfections,  for  the  most 
part  &Ltal,  by  the  general  or  partial  paralysis  of  the  brain — 
affections  generally  incident  to  children  under  five  years  of  age, 
and  manifestiQg  themselves  with  the  development  of  the  attack 
of  scarlet  fever,  and  which  also,  although  much  more  rarely,  are  met 
-with  in  adults ;  and  that  we  shall  likewise  discover  the  proper 
remedies  for  the  diptheritic  affection  of  the  mucous  membrane 
of  the  nose,  palate,  and  fauces,  such  as  commonly  attacks  very 
scrofulous  children  under  ten  years  of  age,  and  often  goes  on  to 
a  rapidly  fetal  termination  in  a  condition  of  stupor. 

Agaiost  the  cerebral  poisoning  by  scarlet  fever,  the  medicines 
hitherto  known  and  employed  which  act  upon  the  brain,  are 
quite  insufficient,  and,  we  see  without  power  to  avert  the  ap- 
proaching paralysis  of  that  organ.  Indeed  there  is  hardly  time 
for  the  efforts  of  the  physician  to  be  effectual,  for  within  four 
or  five  days  the  sad  termination  takes  place.  It  is  probable 
that  in  the  diptheritic  condition  of  the  mucous  membranes, 
Bromine  would  prove  of  more  service  than  Mercury  or  Arsenic, 
which  have  hitherto  been  tried  in  vain. 

A  Case  of  Paratyphlitis. 

Miss  A.  Zeidler,  16  years  of  age,  of  a  scrofulous  constitution, 
with  the  exception  of  measles  and  scarlet  fever,  and  sHght 
catarrhs  from  catching  cold,  had  always  enjoyed  good  health ; 
the  catamenia  also  had  appeared  without  any  difficulties  at  the 
age  of  14,  and  had  always  recurred  at  the  right  time  and  with- 
out irregularity  of  any  kind. 

On  the  29  th  of  May  of  this  year  (1863),  I  was  sent  for  by 
the  mother  of  this  girl  to  see  her.  She  had  suffered  for  several 
days  from  severe  pains  in  the  right  side  of  the  abdomen,  with 
obstinate  constipation.  I  found  the  patient  in  bed,  and  on  a 
close  examination,  I  discovered  a  broad  hard  tumour  in  the 
right  iliac  fossa,  extending  down  to  the  region  of  the  uterus, 
and  above  over  the  junction  of  the  colon  and  ileum.     The 


234  A  Case  of  Hcematuria  and 

tumour  was  very  painful  on  external  pressure ;  in  breadth  it 
was  equal  to  the  palm  of  the  hand ;  faecal  masses  could  be 
distinguished  below  the  surface,  and  between  this  and  them 
a  harder  substance  could  be  felt.  Pressing  upon  this  impac- 
tion, gave  the  patient  stabbing  and  pressing  pains.  The  ab- 
dominal parietes  were  considerably  elevated  by  this  tumour,  as 
was  seen  by  comparing  them  with  the  corresponding  region  on 
the  left  side.  Three  days  previously  the  bowels  had  been  freely 
evacuated  by  a  soap  enema,  since  then  there  had  been  no  pas- 
sage of  either  faeces  or  flatus ;  the  intestinal  canal  consequently 
contained  much  flatus.  The  whole  of  the  rest  of  the  abdomen 
was  entirely  free  from  pain.  The  tongue  was  slightly  coated 
with  white ;  there  was  neither  thirst  nor  appetite,  nor  was  there 
any  eructation  of  wind,  nausea,  or  vomiting.  The  taste  was 
somewhat  insipid  (fade)  wersh  (scottice) ;  the  pulse  70,  not 
hard,  the  head  was  free ;  the  sleep  disturbed  in  consequence  of 
the  pain ;  the  urine  clear  and  pure,  and  of  acid  reaction. 

I  now  got  the  following  report  as  to  the  origin  of  this  attack. 
The  catamenia  had  appeared  six  days  previously  at  the  right 
time,  and  unattended  with  any  pain,  and  had  continued  quite 
regularly  for  two  days ;  on  the  third  the  patient  had  chilled  her 
feet,  and  the  catamenia  began  to  be  interrupted,  and  in  the 
course  of  the  same  forenoon  entirely  ceased.  In  the  afternoon 
of  that  day  the  patient  had  experienced  lively  pain  deep  down 
on  the  right  side ;  and  as  this  had  not  subsided  on  the  fourth, 
and  there  had  been  no  stool,  her  mother  had  given  her  an 
cjioma  of  soap  and  water,  which  had  the  effect  of  emptying  the 
bowels  of  hard  faeces,  but  without  producing  any  mitigation  of 
her  siifferings.  To  the  time  of  my  visit  the  only  remedies  em- 
ployed had  been  some  cups  of  St.  Germain  tea,  with  the  view 
of  moving  the  bowels  and  relieving  the  pain;  but  no  such 
effect  had  followed;  the  steady  increase  in  the  pain  had  at  last 
induced  her  mother  to  seek  my  aid. 

In  consequence  of  the  arrest  of  the  catamenia  by  the  patient 
having  got  a  chill  in  her  feet,  an  inflammatoxy  action  had  been 


A  Case  of  Paratyphlitis.  235 

excited,  which,  extending  firom  the  cellular  tissne  to  the  broad 
legament  of  the  uterus  and  ovarium,  had  advanced  bo  as  to 
involve  part  of  the  colon  and  ileum  and  the  processus  vermi- 
formis ;  and  thus  a  case  of  paratyphlitis  had  resulted  For  the 
tumour  was  not  occasioned  by  the  impacted  faeces  alone,  as  the 
infiltration  of  the  tissues  and  there  tumification  were  palpable 
beneath  and  beside  this  fiecal  mass,  and  the  retention  of  the 
fiseces  was  to  be  regarded  only  as  a  necessary  consequence  of 
this  inflammatory  process.  Such  was  the  diagnosis,  and  it  was 
confirmed  by  the  further  progress  of  the  case. 

Such  being  the  condition  of  affairs,  it  behoved  that  energetic 
measures  should  be  at  once  adopted  to  arrest  the  progress  of 
this  inflammatory  condition  already  far  advanced,  to  avert  a 
disastrous  issue  in  sphacelus,  and  perforation  or  suppuration 
and  adhesion  of  the  different  portions  of  intestines  to  one 
another,  or  to  the  neighbouring  tissues.  Accordingly,  the 
patient  was  ordered  3  drops  of  the  2nd  decimal  dilution  of 
Belladonna  every  three  hours  in  a  little  water,  and  warm  oat- 
meal porridge — ^poultices  were  applied  to  the  abdomen;  for  drink, 
water  which  had  been  boiled  and  allowed  to  cool,  as  the  fresh 
spring  water  produced  eructation. 

On  the  30th  of  May  I  found  the  condition  of  the  patient 
altogether  unchanged;  the  pain  and  the  configuration  of  the 
tumefaction  were  exactly  what  they  had  been,  the  pulse  was 
unaltered,  and  so  was  the  urine.  The  patient  had  had  Uttle 
sleep  in  consequence  of  the  continuous  pain. 

May  31. — No  change  in  the  condition  of  the  patient,  which 
was  exactly  what  it  had  been  on  the  previous  day.  No  dimi- 
nution of  the  pain  or  swelling,  no  discharge  of  feeces  or  of 
flatus.  Sleep  very  restless,  pulse  somewhat  more  excited — 85 
beats  in  the  minute.  Tongue  somewhat  more  thickly  coated ; 
dryness  of  the  mouth  and  more  longing  for  drink. 

June  1. — The  pain  in  the  undiminished  swelling  increased 
during  the  night,  and  as  in  ordinary  cases  of  enteritis  became 
more  severe  at  intervals,  and  of  the  character  of  colic;  no  flatus 


236  A  Case  of  Paratyphlitis. 

or  faeces  passed;  the  urine  is  become  thick,  and  the  pulse  risen 
to  above  100.  The  patient  was  altogether  unable  to  sleep. 
The  thirst  had  increased,  the  tongue  had  become  more  thickly 
coated.  An  enema  of  water  and  oil  was  administered  without 
any  result.  Notwithstanding  all  this,  no  change  was  made  in 
the  medicine. 

June  2. — The  patient  had  had  no  sleep  all  night  in  conse- 
quence of  the  recurrence  at  very  short  intervals  of  the  colicky 
pain  in  the  right  inguinal  region,  and  this  had  produced  the 
greatest  restlessness.  The  swelling,  imdiminished  in  size,  had 
become  excessively  tender,  so  that  the  poultices  required  to  be 
made  very  thin.  The  thirst  as  well  as  the  eructation  were 
much  increased ;  the  severe  paroxysms  of  pain  were  attended 
with  nausea;  no  faeces  or  flatus  passed;  the  urine  was  very 
thick  and  deposited  a  brick-dust  sediment,  its  surface  was 
covered  with  an  non-iridescent  film,  and  it  was  very  pungent ; 
stni  it  had  an  acid  reaction.  Pulse  110  ;  temperature  much 
increased. 

By  the  increase  of  aU  the  morbid  symptoms  the  insufllciency 
of  the  medication  was  manifest,  and  the  question  remained 
whether  the  insufficiency  was  to  be  ascribed  to  the  medicine 
being  given  in  too  small  and  in  too  infrequent  doses,  or  to  its 
not  having  been  rightly  selected.  My  experience  justified  the 
choice  of  the  medicine,  which  had  never  played  me  false  in  the 
worst  cases  of  the  most  advanced  enteritis;  and  I  was  compelled 
to  ascribe  its  failure  in  this  case  to  its  not  being  given  with 
sufl&cient  frequency,  and  to  the  doses  not  being  sufficiently 
large.  There  was  no  time  to  lose,  and  not  to  do  so  by  pre- 
scribing another  medicine  which  was  not  so  suitable  for  the 
case,  I  resolved  to  increase  the  dose  of  this  one  and  to  give 
it  more  frequently.  The  patient  had  from  this  time  five  drops 
of  the  2nd  decimal  dilution  of  Belladonna  in  water  every  two 
hours.     The  poultices  were  continued. 

June  3. — Before  midnight  even,  a  diminution  of  the  con- 
tinued and  colicky  pains  in  the  swelling  and  its  vicinity  took 


A  Case  of  Paratyphlitis.  237 

place.  Towards  morning,  for  the  first  time  for  long,  there  was 
passage  of  flatus.  The  excessive  tenderness  of  the  hard 
swelling  had  much  lessened.  In  the  afternoon,  without  the 
use  of  any  artificial  aid,  some  yellow  and  not  very  hard  faeces 
were  passed.  The  eructation  and  nausea  were  absent.  The 
thirst  was  still  great ;  the  pulse  fallen  to  95  ;  the  temperature 
of  the  skin  was  reduced.  The  urine  as  before;  no  change 
was  made  in  the  treatment. 

June  4. — ^The  patient  had  slept  with  some  interruption,  not- 
withstanding the  recurrence  at  longer  intervals  of  the  colicky 
pain ;  in  the  state  of  the  swelling,  which  was  as  hard  as  ever, 
there  was  no  change,  although  in  the  early  morning  faeces  of 
the  natural  form  had  been  passed  in  abundance ;  they  were  not 
hard,  and  no.  artificial  assistance  was  given;  much  flatus, 
attended  with  great  relief,  was  also  passed.  The  tongue  was 
cleaner,  there  was  no  more  eructation,  the  thirst  was  lessened, 
the  pulse  was  90;  the  urine  thidk,  without  the  film,  and 
with  the  red  sediment.  The  skin  was  of  natural  temperature. 
The  medicine  was  now  given  every  three  hours. 

June  5. — ^The  colicky  pains  have  entirely  subsided,  but  the 
swelling,  which  still  retains  its  old  form,  is  still  very  tender  to 
the  toucL  After  midnight  a  copious  discharge  of  faeces  of  a 
natural  form,  preceded  by  an  emission  of  flatus,  occurred  spon- 
taneously. The  tongue  is  now  almost  clean,  the  thirst  very 
moderate,  the  pulse  85,  the  temperature  natural,  the  urine  re- 
mained clear,  and  had  an  acid  reaction.  The  medicine  was 
now  given  every  four  hours. 

June  6. — ^The  patient  had  slept  the  whole  night  calmly,  felt 
better  in  consequence,  and  desired  some  food.  The  tumour, 
which  has  greatly  diminished  both  in  height  and  breadth^  was 
still  very  painfully  sensitive.  It  was  easy  to  perceive  that  the 
focal  accumulation  had  been  removed,  but  deep  down  a  hard 
oval  body  could  be  distinguished ;  there  was  no  fluid  effusion 
round  this,  for  the  percussion  tone  was  quite  clear  but  quite 
"  empty"  over  this  body.      Pulse  80  ;  urine  clear.     On  this 


238  A  Case  of  Paratyphlitis. 

morning  also  there  was  a  slight  alvine  evacuation.     The  medi- 
cine was  given  only  every  six  hours. 

June  7. — ^The  swelling  could  still  be  distinguished  lying 
deep  backwards,  as  an  oval,  hard,  painful,  body.  The  appetite 
was  strong,  and  was  allowed  to  be  satisfied ;  the  stool  was  of 
natural  figure,  and  very  copious.  Pulse,  urine,  sleep,  were  all 
natural ;  the  strength  returned ;  the  medicine  was  given  only 
night  and  morning. 

After  six  days  I  could  discover  only  the  faintest  trace  of  the 
tumour.  All  the  other  functions  were  normally  discharged, 
there  was  a  daily  and  sufficient  stool,  and  the  patient  felt 
herself  again  quite  strong.  The  medicine  was  however  per- 
severed in  night  and  morning. 

After  other  five  days  every  trace  of  the  tumour  had  entirely 
disappeared,  and  so  all  farther  medication  was  given  up.  In 
due  time  the  catamenia  made  their  appearance  and  ran  their 
nominal  course. 

I  may  now  be  allowed  to  add  some  observations  to  the  nar- 
rative of  the  cure  of  this  severe  disease.  The  reputation  and 
success  of  Hahnemann  and  Homoeopathy  were  begun  and 
grounded  by  the  splendid  early  cures  made  of  very  severe 
diseases,  acute  as  well  as  chronic.  All  these  brilliant  cures 
were  made  with  large,  often  very  large,  powerful  medicines, 
given  in  often-repeated  doses.  The  physiological  provings,  too, 
which  are  contained  in  the  first  volume  of  the  "  Materia  Medica 
Pura,"  were  for  the  most  part  begun  and  carried  through 
with  very  large  doses,  as  I  learned  from  the  communications 
of  Hornburg,  Franz  and  others.  I  was  acquainted  with  a 
Dr.  Anton,  a  relative  of  the  psychologist  Heinroth,  who  had 
also  proved  medicines  for  Hahnemann,  but  who  had  got  them 
in  such  strong  doses  that  they  made  him  seriously  ill,  and 
frightened  him  from  Homoeopathy  altogether. 

Probably  Hahnemann  himself  was  induced  by  a  similar  ex- 
perience in  the  proving  of  medicines,  as  well  as  by  the  occasional 
pathogenetic  effects  produced  upon  patients  by  the  administra- 


A   Case  of  Paraiyphlitis,  239 

tion  of  strong  doses  of  medicines,  to  dilute  the  medicines,  in  order 
to  prevent  this  medicinal  action  in  patients.  From  this  period 
Homoeopathy  entered  into  a  new  phase.  Hahnemann  appeared  to 
have  been  thoroughly  penetrated  by  the  dread  of  too  powerful 
effects  from  the  medicines  in  disease,  and  this  fear  pushed  him  to 
the  opposite  extreme.  This  dread  beclouded  his  otherwise  sober 
and  keen  powers  of  observation ;  every  aggravation  of  disease 
that  occurred  after  the  administration  of  a  medicine  he  attributed 
without  further  proof  to  the  effects  of  the  medicine  taken,  and 
it  was  this  dread  which  led  him  to  promulgate  the  dogma  that 
the  most  minute  dose  was  sufficient  to  cure  the  severest  disease, 
and  ultimately  induced  him  to  announce  the  theory  of  poten- 
tizatipn,  a  theory  destitute  of  all  foundation  upon  facts.  It  was 
necessity  alone  which  compelled  Hahnemann  from  time  to  time  to 
lid  himself  of  this  fear  of  the  too  powerful  effects  of  drugs ;  as 
for  example,  when  he  found  it  necessary  to  administer  Camphor, 
both  externally  and  internally,  in  strong  doses,  in  cases  of  the 
prevailing  epidemic  of  Asiatic  cholera. 

Hahnemann's  sphere  of  practice  had  in  the  course  of  time 
become  so  peculiarly  constituted,  that  he  was  withdrawn  from 
the  direct  inspection  and  observation  of  all  acute  diseases.  In 
Leipsig,  as  well  as  at  Koethen,  he  saw  only  patients  who  were 
able  to  go  to  him,  and  these  were  for  the  most  part  the  sufferers 
from  chronic  diseases.  It  was  probably  this  fact  which  gave 
him  so  strong  a  preference  for  this  class  of  patients, — a  pre- 
ference which  carried  him  so  far  that  he  gave  both  myself  and 
my  deceased  colleague,  Dr.  Wolf,  the  advice  to  decline  under- 
taking the  treatment  of  acute  cases !  In  this  way,  all  acute 
cases  had  to  a  certain  extent  become  strange  to  him,  and  had 
been  kept  entirely  out  of  his  sight,  and  this  necessarily  induced 
in  him  a  certain  one-sidedness.  In  chronic  diseases  he  had 
gone  so  far  as  to  have  noted  down  each  particular  symptom 
which  made  its  appearance  in  a  patient,  it  might  be  weeks 
after  the  administration  of  a  medicine,  and  these  notes  com- 
posed  the   greater   part  of  the  materials  out  of  which   the 


240  A  Case  of  Paratyphlitis, 

provings  of  the  so-called  antipsoric  medicines  were  derived. 
Hence  the  efforts  of  my  respected  friends  Dr.  Eoth  and  Dr. 
Langheinz,  of  Darmstadt,  are  not  only  worthy  of  the  highest 
praise  and  fullest  recognition,  but  the  work  in  which  they  are 
engaged  is  of  the  most  urgent  kind, — for  the  purification  of 
the  Materia  Medica  is  a  work  of  absolute  necessity. 

It  is  now,  however,  full  time  that  the  dogma  just  referred 
to  should  be  struck  out  of  the  Organon,  and  that  the  potenti- 
zation  theory  should  be  given  up  as  a  part  of  the  doctrine 
of  medicinal  action, — ^being,  as  it  is,  in  direct  antagonism  to 
all  experience.  I  have  said  even  to  Hahnemann's  face,  and 
demonstrated  to  himself  the  fact,  that  it  is  not  possible  to 
potentize  into  more  powerful  efficacy  upon  the  animal  economy, 
wine  and  alcohol,  by  the  addition  of  water,  and  that  both  these 
substances  must,  according  to  his  own  definition  of  what 
medicines  are,  be  reckoned  sucL  He  never  replied  to  this 
representation. 

The  foregoing  narrative  of  the  cure  of  so  serious  a  disease, 
affords  us  a  fact  of  important  consequence.  It  demonstrates 
that  the  operation  of  a  well-chosen  medicine  in  small  doses, 
repeated  at  considerable  intervals,  is  often  insuf&cient  to  cure, 
but  that  by  increasing  the  strength  of  the  dose  and  repeating  it 
more  frequently,  the  intensity  of  the  disease  may  be  broken  and 
overpowered,  and  its  cure  achieved. 

Note.  Langheinz,  whose  name  is  but  little  known  in  this 
country,  published  an  article  in  the  recent  number  of  the 
"  Vierteljahrshrift "  upon  Opium.  He  states  that  out  of  518 
symptoms  to  which  the  references  gave  him  access  no  less  than 
210  ought  to  be  struck  out.  He  shows  the  symptoms  of  Matthaei, 
Machart,  Hunter,  Eademacher  were  observed  principally  in 
persons  suffering  from  iUness,  also  those  by  Young,  and  the  pre- 
parations he  employed  were  not  pure,  that  Schillhammer's  opium 
was  combined  with  crocus,  iEplis  with  rhubarb ;  also  Miiller 
and  Stutz  employed  mixtures,  while  those  of  Friend,  Bergius, 
Murray,  Geofifroy,  EttmiiUer,  WiUis,  and  Haller  were  merely  such 
hypothetical  symptoms  as  are  found  in  the  manuals.  Buoff's 
symptoms  are  utterly  worthless. 


A  Case  of  Paratyphlitis,  241 

I  could  bring  forward  likewise  other  cures  of  acute  and 
chronic  diseases  to  confirm  these  facts,  and  I  will  do  so  if  God 
should  grant  me  a  longer  life.  I  wished,  however,  by  the  com- 
munication of  the  one  experience,  to  make  my  Mends  observant 
of  this — that  we  must  resolve  to  leave  the  path  which  Hahne- 
mann has  hitherto  marked  out,  that  we  must  make  up  our 
minds  to  accommodate  the  dose  of  the  medicine  to  the  degree 
of  intensity  of  the  disease  we  treat,  that  we  must  abandon  as 
an  error  that  a  small  or  the  smallest  dose  is  sufBicient  for  the 
cure  of  every — even  the  severest  of  diseases.  This  is  demanded, 
as  well  on  account  of  suffering  humanity,  as  because  it  is  a 
fancy  equally  destructive  to  science,  and  one  which  undermines 
the  strength  and  power  of  the  Homoeopathic  system  of  medi- 
cine, and  deprives  it  of  its  full  value  and  recognition. 

DISCUSSION. 

Me.  Teldham  said, — ^Albuminuria,  it  was  now  well  ascertained, 
since  it  had  become  the  custom  to  analyze  the  urine,  was  by  no 
means  a  rare  occurrence,  and  probably  it  was  much  more  common 
than  was  even  now  imagined.  The  most  frequent  cause  of  it 
was  beyond  a  doubt,  a  previous  attack  of  scarlet  fever.  It  was 
generally  said  to  bear  a  close  relation  to  the  severity  of  the  skin 
diseasa  It  might  be  so ;  but  the  rule  had  large  exceptions — of 
this  he  was  perfectly  satisfied  from  his  own  experience.  Nor 
did  he  think  that  exposure  to  cold,  and  errors  in  diet  after  scar- 
latina, had  much  to  do  with  inducing  albuminuria.  He  had 
treated  many  cases  in  which  every  precaution  in  these  respects 
was  taken,  and  yet  dropsy  had  occurred.  He  believed  the  great 
predisposing  cause  to  be  a  peculiar  delicate  scrofulous  constitu- 
tion. Not  long  ago  he  had  a  whole  family  of  children  under 
care  with  mild  scarlet  fever  who,  under  his  own  strict  injunctions, 
were  taken  the  greatest  care  of,  to  prevent  chill  or  improper 
feeding,  because  he  anticipated,  from  the  temperament  of  the 
children,  that  dropsy  would  follow,  and  his  prediction  proved 
but  too  true.  They  were  all  pale-faced,  delicate  children,  and 
all  had  anasarca.  He  would  not  dwell  on  the  treatment  of  albu- 
minuria after  scarlatina ;  on  that  they  were  pretty  well  agreed. 
In  Aconite,  Arsenic,  Hellebore,  Cantharis,  and  Terebinth,  they 
possessed  very  powerful  and  generally  successful  remedies. 
When  albuminuria  occurred  as  the  result  of  Bright's  disease, 
it  was  very  questionable  whether  any  treatment  would  succeed. 

VOL,  ni.  16 


242  A  Case  of  Albumimcria  and 

He  thought  Dr.  Trinks'  selection  of  China  very  interesting.  He, 
Mr.  Yeldham,  regarded  that  medicine,  in  low  dilutions,  as  a  most 
important  medicine  in  many  cases  of  atonic  inflammation.  He 
believed  that  it  excited  the  contractility  of  the  capillary  vessels, 
pathogenically  on  the  healthy  body,  curatively  in  disease — Whence 
its  relation  to  ague — hence  its  power  in  averting  haemorrhage — 
hence  its  curative  action  in  inflammation,  which  consisted  in 
dilatation  of  the  capillaries.  He  thought  they  were  much  indebted 
to  Dr.  Trinks  for  the  examples  he  had  given  of  the  good  effects  of 
low  dilutions,  as  they  were  also  indebted  to  those  gentlemen,  who, 
on  the  other  hand,  exemplified  the  effects  of  the  high  dilutions. 
All  this  went  to  confirm  the  opinion  which  he  believed  was  en- 
tertained and  acted  upon  by  the  soundest  practitioners  of 
Homceopathy,  viz.,  that  all  the  dilutions  of  medicines  were  curative 
in  certain  cases,  and  that  he  was  wisest  who  restricted  himself 
to  no  particular  dilution,  but  availed  himself,  as  circumstances 
might  require,  of  all  of  them. 

Dr.  Wyld  (of  London),  did  not  think  that  much  was  to  be 
learned  from  the  case  of  albuminuria  following  scarlatina  which 
had  been  just  read.  This  was  a  very  common  affection,  and  very 
easily  cured  inthegreatmajority  of  cases.  Dr.  Wyld  had  had  two 
cases  of  chronic  albuminuria  under  his  care,  accompanied  by 
general  anasarca.  These  cases  had  lasted  for  years,  but  no  treat- 
ment seemed  much  to  reduce  the  amount  of  albumen  in  the 
urine,  although  the  swelling  and  anasarca  had  nearly  disappeared 
in  the  one  case  under  grain  doses  of  the  black-oxide  of  iron,  and 
in  the  other  case  during  a  month's  residence  in  the  country.  In 
this  second  case  the  dropsical  swellings  had  returned,  and  on  one 
occasion  the  patient  became  comatose  for  two  days,  but  recovered 
under  Opium  3  and  Arsen.  3.  Apis  appeared  to  do  most  good 
in  one  of  the  cases.  Both  cases  resulted  probably  from  degeneration 
of  the  kidneys,  although  neither  casts  nor  blood  discs  have  been 
observed  in  the  urine.  Dr.  Wyld  would  be  glad  to  know  if  any 
gentleman  present  had  ever  succeeded  in  curing  chronic  albumin- 
uria, the  result  apparently  of  kidney  disease.  Arsenicum  was 
probably  our  best  remedy,  but  in  both  the  cases  referred  to  it 
had  failed  to  do  much  good.  With  regard  to  the  case  called 
paratypJditis,  it  did  not  appear  very  clearly  made  out  There 
appeared  to  have  been  the  presence  of  a  tumour  without  any  in- 
flammatory action  to  begin  with,  and  secondly  the  tumour  was 
felt  as  "  an  oval  moveable  tumour.''  Was  it  a  phantom  tumour, 
or  was  it  a  moveable  kidney?  The  cure  being  effected  by  Bella- 
donna might  to  some  extent  point  to  an  hysterical  origin.  Dr. 
Wyld  had  seen  an  hysterical  tumour  which  perfectly  simulated 
a  hard  fibrous  tumour,  but  which  always  melted  away  when  the 
patient  was  placed  under  chloroform,  and  re-formed  as  the 
influence  of  that  drug  subsided. 


A  Case  of  Paratyphlitis.  243 

Dr.  Hughes  said — I  heartily  join  in  the  admiration  generally 
expressed  for  this  and  all  other  practical  papers  by  Dr.  Trinks. 
I  agree  with  him,  that  the  renal  affection  is  not  an  accident  in- 
cident to  the  convalescence  from  scarlet  fever,  but  is  of  the  essence 
of  the  malady.  But  I  think  we  should  draw  an  incorrect  in- 
ference from  his  narrative,  if  we  concluded  that  the  China  exercised 
any  direct  curative  influence  upon  the  congested  kidneys.  There 
is  no  evidence  that  China  is  a  specific  irritant  of  the  renal  paren- 
chyma, like  Terebinthis,  Cantharis,  Arsenicum,  and  Mercurius 
Corrosivus ;  and  it  can  never  take  the  place  of  either  of  these 
remedies  in  the  treatment  of  nephritis.  Its  value  in  the  case 
before  us  seems  to  me  purely  dependent  on  its  well-known  power 
of  antidoting  the  bad  effects  of  loss  of  blood,  from  which  Dr. 
Trinks'  patient  was  plainly  suffering  when  he  saw  her.  I  have 
no  doubt  that  he  acted  wisely  in  treating  this  serious  general 
effect  of  the  local  mischief,  and  leaving  the  latter  to  right  itself ; 
but  it  is  important  that  we  should  understand  this  to  be  the  true 
rationale  of  his  successful  treatment.  I  have  not  met  with  the 
paralysis  of  the  brain  in  scarlatina,  of  which  Dr.  Trinks  speaks 
so  despairingly ;  but  the  experience  of  Dr.  Elb  of  Dresden,  and 
others,  would  seem  to  prove  that  we  have  in  Zinc  a  very  potent 
remedy  for  such  a  condition.  The  diphtheritic  complication  I 
have  found  almost  universal  in  severe  cases;  and,  except  in 
malignant  forms  of  the  disease,  have  much  confidence  in  the 
Biniodide  of  Mercury  for  its  removal  With  regard  to  the 
■  second  case,  I  cannot  agree  with  Dr.  Wyld,  in  the  doubt  he  has 
raised  as  to  the  diagnosis.  I  think  the  inflammatory  nature  of 
the  disease  very  plain ;  but  regret  that  Dr.  Trinks  seems  to  have 
left  out  of  sight  in  his  treatment  the  evident  implication  of  the 
peritoneum  in  this  process.  I  cannot  but  think  that,  had  he 
recognized  this,  he  would  have  found  much  help  from  Mercimus 
Corrosivus  in  the  management  of  the  caso..  I  look  upon  this 
medicine  as  almost  infallible  when  in  inflammation  of  any  of  the 
abdominal  organs,  the  peritoneal  covering  becomes  implicated  in 
the  morbid  process.  I  well  remember  a  case  of  ovaritis  in  which  the 
y]i  Corrosidfe  Sublimate — ^the  first  medicine  administered-^-removed 
/  in  a  few  hours  the  sharp,  cutting  pain  of  serous  inflammation, 
and  left  behind  the  dull,  sickening  misery  characteristic  of 
ovarian  congestion, — which  in  its  turn  yielded  beautifully  to  the 
steady  use  of  Pulsatilla.  I  am  compelled,  moreover,  to  question 
the  Homoeopathicity  of  Belladonna  to  a  malady  of  this  nature, 
and  to  doubt  very  strongly  whether  it  contributed  much  towards 
the  recovery  of  this  patient.  Dr.  Trinks  tells  us  that  he  per- 
severed with  the  drug,  because  in  the  worst  cases  of  enteritis  in 
the  highest  stage,  it  had  never  refused  him  its  aid.  But  surely, 
upon  fir,  Trinks'  own  showing,  this  was  no  case  of  enteritis,— 

10^ 


244  A  Case  of  AlhuminuHa  and 

by  which  I  suppose  he  means,  as  we  do  in  England,  inflammation 
of  the  intestinal  mucous  membrane.  And  the  history  of  the  case 
seems  to  show  the  disease  progressing,  imchecked,  to  its  acme, 
and  then  as  steadily  declining.  I  cannot  think  that  the  mere 
increase  of  two  drops  in  dose,  and  diminution  of  one  hour 
in  the  intervals  between  the  doses,  had  anything  to  do  with  the 
turn  of  the  malady. 

Dr.  Drury  regretted  very  much  to  find  that  instead  of  that 
harmony  and  brotherhood  that  ought  to  exist  in  the  Homoeopathic 
body,  tliore  was  every  day  becoming  more  prominent  a  spirit  of 
opposition  and  disbelief — what  one  gentleman  asserted,  was 
contradicted  by  some  one  else,  and  much  good  was  lost  by  a 
wholesale  condemnation  of  those  who  differed,  without  any  at- 
tempt being  made  to  extract  what  reaUy  was  valuable,  from  a 
dislike  to  the  individual,  or  to  the  particular  school  to  which  he 
belonged.  On  the  present  occasion,  there  was  a  paper  by  Dr. 
Trinks,  that  really  might  have  been  dispensed  with.  It  came  as 
a  flat  contradiction  to  what  had  been  so  well  and  so  completely 
stated  by  the  President.  Indeed,  the  address  aUuded  to,  so  com- 
pletely answered  tliis  paper  by  anticipation,  that  had  it  fallen 
undor  the  notice  of  the  learned  foreigner,  whose  cases  had  just 
been  narrated,  the  Society  might  have  been  spared  hearing  a 
repetition  of  eiTors  that  had  been  so  ably  refuted  by  Dr.  Quin. 
In  the  tli^t  case  that  had  been  read,  he.  Dr.  Drury,  could  give 
no  credit  to  the  China  beyond  the  good  it  very  likely  produced 
by  being  given  after  Haemorrhaga  In  cerebral  affections  he  had 
a  vtny  high  opinion  of  Hyoscyamus,  and  had  used  it  freely  with 
groat  success.  A  very  interesting  case  that  just  came  into  his 
mind — that  of  a  little  child  w^ho  suffered  from  several  derange- 
ments of  vision,  preventing  her  reading,  following  diphtheria, — 
the  double  vision  and  other  symptoms  disappeared  under  the  use 
of  Hyoscyamus.  In  the  case  where  Belladonna  was  given,  it  ap- 
peared to  be  indicated  by  the  tumour,  but  if  instead  of  giving 
stronger  doses,  a  higher  potency  had  been  given,  a  better  result 
might  have  been  obtained.  While  using  other  medicines 
when  indicated  for  ovaritis,  he,  Dr.  Drury,  had  the  highest 
opinion  of  the  action  of  Conium. 

Dr.  Wilde  (of  Winchester), — I  have  recently  seen  a  good  deal 
of  scarlet  fever  in  Winchester.  In  most  of  the  cases,  very  severe 
throat  affections  occurred,  and  in  a  great  number  hsematuria  with 
anasarca.  I  found  that  where  Belladonna  had  not  been  used  at 
the  outset  of  the  disease,  in  consequence  of  my  not  seeing  the 
cases  earlier,  that  medicine  was  very  useful  in  alternation  with 
Arsenicum,  during  the  nightly  fever,  delirium,  and  restlessness  ^ 
which  accompanies  the  anasar^ous  condition.  I  had  one  very  |(^ 
interesting  case  of  paralysis  after  scarlet  fever,  occumng  in  a 


A  C<x8e  of  Paratyphlitu.  245 

cliild  two  years  of  age.  After  the  patient  had  passed  well 
through  the  rash  and  a  severe  throat  affection,  and  seemed  to  be 
rallying  from  the  attack,  1  was  sent  for  suddenly  to  see  the  child. 
On  arriving  at  the  house,  I  found  the  little  patient  lying  in  the 
lap  of  his  mother,  in  a  semi-comatose  state,  with  dilated  pupils, 
and  perfect  loss  of  motion  of  the  left  arm  and  leg,  with  great  dis- 
tension and  fullness  of  the  veins  of  the  scalp,  and  much  heat 
about  the  head.  Belladonna  was  administered,  but  with  ap- 
parently no  good  effect.  I  then  tried  Zincmn  Met,  which  com- 
pletely removed  the  paralysis,  and  the  child  recovered  after  three 
or  four  days. 

Me.  Cameron.  It  is  with  great  deference  to  so  eminent  and 
and  experienced  a  physician  as  Dr.  Trinks  that  I  venture  to  call 
in  question  the  value  which  he  sets  upon  the  directly  curative 
effects  of  China  in  the  cure  of  albuminuria  and  hsematuria.  Not- 
withstanding his  authority,  I  own  that  I  am  very  sceptical  as  to 
the  great  importance  of  any  one  remedy  in  the  treatment  of 
symptoms  like  these,  which  so  often  depend  upon  many  and  very 
different  pathological  conditions.  We  know  very  well  that  albu- 
minuria and  haematuria  are  symptoms  that  may  often  arise 
simply  from  a  morbid  state  of  the  digestive  or  other  organs,  un- 
connected with  any  structural  lesion,  temporary  in  their  duration, 
and  that  will  disappear  without  any  special  treatment,  while 
again  in  other  instances  they  denote  the  most  incurable  and 
deadly  structural  diseases.  Owing  chiefly  to  the  serious  nature  of 
albuminuria  in  Bright's  disease,  and  to  the  rather  sweeping  gene- 
ralizations of  that  and  some  other  eminent  writers,  a  degree  of 
importance  has  become  associated  with  the  smallest  appearance 
of  this  symptom  in  any  case,  which  it  does  not  always  deserve. 
In  some  patients,  for  instance,  albuminuria  is  readily  produced 
by  a  dose  of  Calomel  or  other  preparation  of  Mercury.  Some 
people  experience  it  after  a  full  meal,  and  lose  all  trace  of  it  next 
day.  I  know  a  gentleman,  in  fair  average  health,  who  has  had  it 
for  more  than  twenty  years.  Another  gentleman,  who  goes 
through  a  great  amount  of  mental  and  bodily  work,  has  been 
subject  to  albuminuria  at  intervals  for  many  years,  and  regards 
an  attack  of  it  as  rather  curative,  as  he  feels  better  after  than 
before  it.  In  short,  there  seems  to  be  no  reason  to  question  the 
opinion  of  many  Pathologists  who  maintain  that  this  appearance 
may  often  depend  entirely  on  errors  of  digestion  of  a  very  simple 
and  unimportant  kind,  and  that  in  these  cases  the  symptom  is 
owing  to  the  mode  in  which  the  pabulum  is  presented  to  the 
kidneys  for  secretion.  The  same  general  remarks  apply  to 
hematuria — ^it  is  often  unconnected  with  any  local  disease,  arising 
in  such  cases  from  a  generally  morbid  condition  of  the  system, 
and  disappearing  when  that  condition  has  been  removed.     It 


246  Cases  of  Ophthalmia, 

frequently  occurs, withoutanylesioii,in  purpura, scurvy, sinall-po3t, 
typhus  and  other  low  forms  of  disease,  and,  in  these  cases,  takes 
its  departure  without  any  other  treatment  except  the  general  one 
employed  for  the  removal  of  the  adynamic  condition  of  the  sys- 
tem. Although  these  and  other  similar  arguments  cause  me  to 
doubt  the  directly  curative  action  of  China  in  the  interesting  case 
reported  by  Dr.  Trinks,  I  am  very  far  from  calling  in  question  the 
perfect  propriety  of  his  treatment,  as  I  believe  that  in  the  ex- 
hausted state,  and  hsemorrhagic  tendency  of  the  patient,  it  was  the 
most  appropriate  remedy  that  could  be  used.  I  am,  however, 
equally  persuaded  that  it  acted  by  relieving  the  generally 
adynamic  condition  of  the  patient,  and  not  by  any  immediate 
Homoeopathic  or  specific  influence  over  the  kidneys,  just  as  it 
does  in  cases  of  scurvy,  purpura,  or  typhus,  accompanied  with 
haematuria  in  removing  this  symptom.  I  cannot  sit  down  without 
expressing  my  regret  that  Dr.  Eussell  has  been  called  away  before 
the  reading  of  this  paper.  Had  he  been  present  he  woidd  have 
explained  to  us  what  amount  of  importance  was  to  be  attached 
to  the  observations  of  Dr.  Trinks  in  regard  to  the  practice  and 
opinions  of  Hahnemann  at  different  periods  of  his  career,  obser- 
vations which  he  believed  to  be  entirely  at  variance  with  those 
of  other  credible  witnesses ;  and  he  feared  that  unless  they  were 
now  met  with  a  distinct  contradiction,  they  would  be  admitted 
unchallenged  in  future  into  the  History  of  Homoeopathy. 


CASES  OF  OPHTHALMIA,  WITH  OPACITY  OF  THE 

COENEA. 

By  Dr.  Ozanne. 
The    following   cases  are  doubly  interesting  to  the  Homoeo- 
pathic practitioner,  inasmuch  as  they  show  the  power  of  his 
remedies  in  effecting   a  cure  where  the  ordinary  or  classical 
treatment  had  previously  failed. 

Case  l. — Mary  Anne  Duffy,  a  very  interesting  little  girl,  3 
years  old,  was  brought  to  the  Homoeopathic  Dispensary  on  the 
14th  September,  1860.  About  five  or  six  weeks  previously  she 
had  an  attack  of  measles.  At  first  she  was  under  the  care  of 
one  of  the  parish  surgeons,  but  subsequently  was  trans- 
ferred to  that  of  his  colleague.  Before  the  measles  had 
subsided  one  of  her  eyes  became    inflamed.     The  case    was 


with  Opacity  of  the  Cornea,  247 

treated  most  carefully  in  the  usual  way ;  leeches  were  applied 
twice,  the  child  was  blistered,  the  eye  was  fomented  with 
decoction  of  poppies ;  and  subsequently  the  eye  was  touched 
every  day  with  a  small  brush  soaked  in  some  medicated  solu- 
tion In  addition  to  these  measures  internal  remedies  were 
at  the  same  time  administered. 

Notwithstanding  this  careful  treatment,  the  appearance  of 
the  eye,  when  I  first  saw  it,  was  most  alarming.  The  whole 
of  the  eye-ball  seemed  much  swollen,  the  conjunctiva  injected 
red  and  swollen ;  the  cornea  was  opaque,  as  if  painted  over 
with  a  thick  coating  of  starch,  and  appeared  to  me  to  be,  as  I 
noted  down  at  the  time,  **  disorganized."  The  child  had  quite 
lost  her  appetite,  and  had  much  fallen  off  in  flesh. 

My  prognosis  was  in  this  state  of  things,  of  the  most  dis- 
couraging character,  for  I  must  confess  I  looked  upon  the  eye 
as  irrevocably  lost. 

Aconitum   1,  six  drops  in  three  ounces  of  water,  a  teaspoonful 
every  two  hours. 

Sept.  15. — Much  pain.  No  change  in  the  appearance  of 
the  eye. 

Belladonna  1,  6   drops  to  two  ounces  of  water,  a  teaspoonful 
every  three  hours. 

Sept.  17. — ^The  pain  diminished.  Less  swelling  and  less 
redness. 

Merc.  cor.  2. 
Sept.  19. — Pain  much  relieved. 

Eepeat  Merc.  cor. 
Sept  21. — Still  some  redness  of  the  conjunctiva;  the  pain 
much  better. 

Aconitum  for  three  days,  six  dix)ps  to  three  ounces  of  water,  a 

desert  spoonful  three  times  a  day. 

Sept.  24.     The  eye  generally  much  improved;  the  signs  of 

inflammation  disappearing.     The  cornea  much  improved,  the 

ulcerations  healing,  and  its  general  opacity  less. 

Repeat  Aconitum. 


248  Cases  of  Ophthalmia, 

Sept.  26. — ^Much  the  same. 
Merc.    cor.  for  five  days,  six  drops  to  three  ounces  of  water,  a 
desert  spoonful  for  three  days. 
Sept.    29. — General   improvement  continued.     Cornea  be- 
coming more  transparent. 

Belladonna  for  three  days,  six  drops  to  three  ounces  of  water. 
Oct  2. — Much  the  same. 

Merc.  cor.  for  five  days. 

Oct.  5. — ^Diarrhoea,  many  watery  motions  since  the  previous 
day. 

Veratrum  albm.    2,   six   drops  to  three  ounces   of  water,  a 
teaspoonftd  every  two  hours. 
Oct.  6. — Bowels  quite  well,  eye  better,  cornea  healthier  and 
gaining  in  transparency. 

Merc.  cor.  for  five  days. 
Oct  9. — The  child  had  taken  cold,  had  a  cough,  and  redness 
of  the  lids  of  the  good  eye.    Cornea  getting  clearer. 
Aconitum  for  fivei  days,  six  drops  to  three  ounces  of  water,  a 
teaspoonful  four  times  a  day. 
Oct.  13. — Improving. 

Belladonna,  for  three  days. 
Oct.    16. — Eye   much  improved;    the    opacity  had  so  far 
diminished  that  I  could  see  the  whole  outline  of  the  pupiL 
Merc.  cor.  for  five  days. 
Oct.   19. — Cornea  getting  more  and  more  transparent,  the 
inner  half  being  alone  opalescent     The  eye  appeared  to  be 
more  of  its  natural  size. 

Bepeat  Mer.  cor. 
The  child  remained  under  treatment  until  the  10th  Dec, 
taking  in  succession  Camabis  Sativa  1,  Aurum  m.  3,  Belladonna 
4,  Camabis  Sativa  1,  and  Merc.  cor.  for  five  days  and  six  days; 
at  the  end  of  which  course  the  eye  was  completely  restored 
to  its  original  state. 

The  above  notes  are  transcribed  almost  word  for  word  from 
the  case  as  drawn  out  at  the  time ;  they  are  necessarily  very 


with  Opacity  of  the  Cornea.  249 

incomplete,  but  nevertheless  suffice  to  show  that  the  ordinary 
treatment  had  most  signally  failed  in  every  respect.  It  had 
failed  to  relieve  the  pain,  had  failed  to  remove  the  inflamma- 
tion, and  had  failed  to  avert  the  serious  consequences  which 
result  from  badly-treated  cases  of  ophthalmia,  when  these  are 
severe. 

Quite  recently  I  have  had  a  case  in  every  respect  similar  to 

the  above,  in  a  little  girl  aged  20  months,  AdaE ^  but 

having  been  fiK)m  the  first  under  Homoeopathic  treatment,  the 
results  have  been  far  different.  By  means  of  Aconitum  1,  and 
subsequently  Belladonna  1,  and  Merc.  soL,  2  dec.,  trit.,  the  in- 
flammation and  its  e£fects  have  been  removed  in  a  very  short 
time  without  any  damage  whatever  to  the  cornea. 

I  may  safely  say  that  the  case  of  Mary  Anne  Dufiy  was  one 
of  the  worst  that  could  be  imagined,  and  yet  the  result  was  all 
that  could  be  wished  for. 

Case  2. — Sarah  Cameron,  aged  11,  daughter  of  a  sergeant  quar- 
tered at  Fort  George,  had  been  from  three  to  four  weeks  imder 
the  treatment  of  the  Surgeon  to  the  Eoyal  Artillery.  Collyria 
externally,  and  powders  internally,  had  been  regularly  ad- 
ministered. 

On  29th  September,  1862,  the  lids  of  both  eyes  were  red 
and  swollen,  the  conjunctiva  much  injected.  The  left  eye  worse 
than  the  right. 

Aconitum  1,  10  drops  to  4  ounces  of  water,  a  teaspoonful  every 
two  or  three  hours. 

Oct.  1. — Both  eyes  much  better. 

Belladonna  3,  12  drops  to  4  ounces  of  water. 

Oct  3. — ^The  improvement  continued.     Two  patches  of  red- 
ness in  the  globe  of  the  left  eye ;  some  excoriation  of  the  edges 
of  the  eye-lids. 
Merc.  cor.  for  4  days,  to  be  followed  by  Merc.  soL  five  times  a  day. 

Oct.  6. — Improving. 

Eepeat  the  same. 

Oct  10. — ^Much  better,  excepting  some  photophobia. 
Belladonna  for  four  days. 


250  Cases  of  Ophthalmia, 

Oct.  13. — Still  a  little  injection  of  the  eyes.     This  appears 
to  be  kept  up  by  exposure  to  strong  currents  of  air,  the  Fort 
being  in  a  very  high  and  exposed  situation. 
Merc.  cor.  for  six  days. 

Oct.  20. — Much  better. 

Bepeat  the  same. 

Oct.  29. — Eight  eye  much  inflamed  (a  most  decided  relapse). 
Aconitum  1,  8  drops  to  4  ounces  of  water;  a teaspoonful  every 

three  hours. 

Nov.  1. — Eyes  better.     I  now  detected  a  small  ulceration  in 

the  comer  of  the  right  eye.     Whether  it  existed  previously  or 

not  I  could  not  feel  sure,  as  untU  now  I  could  not  make  so 

thorough  an  examination  of  the  cornea  as  I  could  have  wished 

Mer.  cor.  2,  10  drops  to  4  ounces  of  water. 

From  this  date  the  medicines  given  were  Mer.  cor.  3  and  5, 
Aconitum  for  3  days  for  another  relapse  on  the  29th  November, 
and  SUicea  5.  On  the  26th  December  the  eyes  were  perfectly 
well. 

Since  then  Sulphur  5,  2,  and  12  have  been  prescribed  for  a 
herpetic  eruption  on  the  occiput. 

This  case,  although  not  a  severe  one,  is  interesting  on  account 
of  the  failure  of  the  Allopathic  treatment,  and  of  the  manifest 
improvement  which  soon  took  place  under  the  new  treatment; 
and  the  final  cure  in  the  most  unfavourable  season  of  the  year 
and  under  unfavourable  circumstances. 

Case  3. — A.  — ,  a  delicate  young  woman,  aged  16,  was 
brought  to  me  on  28th  November,  1862. 

She  had  been  affected  with  ophthalmia  over  nine  weeks.  At 
first  there  was  very  much  pain,  photophobia  and  lachrymation. 
She  was  at  once  placed  under  the  care  of  an  Allopathic  surgeon, 
who,  in  addition  to  a  course  of  medicine  internally,  applied 
blisters  on  the  temples,  and  subsequently  instilled  caustic  solu- 
tion into  the  eye. 

When  I  first  saw  her,  there  was  so  much  pain  in  the  eyes 
and  photophobia,  that  it  was  impossible  to  ascertain  the  state 


with  Opacity  of  the  Cornea,  251 

of  the  comea  of  either  eye.  She  informed  me  that  at  first 
"  everything  before  her  eyes  looked  like  fire,"  then  everything 
became  quite  dark.  For  about  a  week  she  could  see  the  light 
of  day,  but  as  if  through  a  thick  cloud. 

Belladonna  for  2  days,  12  drops  to  6  ounces  of  water,  a  dessert- 
spoonful every  four  hours. 
Dec.  1. — Her  mother  reports  that  she  cotdd  open  her  eyes  a 
little   yesterday,  and   bears  the   light  of  the   candle  better. 
Shooting  pain  in  the  nose. 

Bepeat  Belladonna  for  2  days. 
Dec.  5. — ^A  cold  and  cough.     Eyes  much  the  same  they  say, 
but  bears  the  light  better,  and  can  open  the  eyes  better. 
Belladonna  for  5  days,  12  drops  to  6  ounces  of  water,  a  dessert- 
spoonful every  four  hours. 
Dec.  9. — I  saw  her  this  day  and  was  able  to  examine  her 
eyes  carefully,  as  she  was  able  to  open  them.      I  found  the 
comea  in  each  eye  quite  opaque.     She  was  able  to  see  the 
shadows  of  objects,  but  could  discern  nothing. 
Mer.  cor.    2,    6    drops   in  8   spoonfuls  of  water,  a  spoonful 
every  four  hours. 
Dec.  11. — StiU  a  cough.     Sight  improving.     Last  evening 
could  see  her  own  fingers,  but  they  appeared  very  dark  in 
colour,  and  much  larger  than  naturaL 

Mer.  cor.  2,  12  drops  to  6  ounces  of  water,  a  dessert-spoon- 
ful every  four  hours. 
Dec.  15. — Sight  continues  to  improve,  and  the   comea  is 
getting  clear.     White  objects  appear  yellow  to  her,  and  brown 
seem  to  be  black.     Some  toothache  since  the  13th. 
Aconitum  for  1  day,  8  drops  to  4  ounces  of  water ;  a  dessert- 
spoonful every  two  hours. 
Dec.  18. — ^Toothache  better.     She  can  see  smaller  objects. 

Mer.  cor.  2,  12  drops  to  6  ounces  of  water, 
Dec.  20. — I  called  to  see  her,  and  found  the  right  comea 


262  Cases  of  Ophthalmia, 

still  very  opaque,  but  the  left  more  transparent,  especially  at  its 
upper  part. 

Eepeat  the  Mer.  cor. 
Dec.  22. — Much  the  same. 
Silicea  5,   12  drops  to  6  ounces  of  water;  a  dessert-spoonful 
four  times  a  day. 
Dec.  26. — The  sight  continues  to  improve.     She  is  now  able 
to  see  objects  and  to  recognize  them,  though  not  distinctly 
Bepeat  Silicea  5. 
Dec.  30. — Continues  to  improve. 

Merc.  cor.  five  times  a  day,  as  before. 
Jan.  5. — ^The  improvement  continues ;  she  is  now  able  to  see 
a  little  with  the  right  eye. 

Silicea  5. 
Jan.  9.  —  Improving. 

Mer.  cor.,  four  times  a  day. 
Jan.  13. — Improving. 

Silicea  5. 
Jan.  21. — ^Mer.  cor.,  five  or  six  times  a  day. 
Jan.  26. — ^The  right  eye  is  getting  on  as  well  as  the  left. 
Her  mother  says  that  she  can  see  wonderfully  better,  having  been 
able  to  discern  her  face,  and  to  read  aU  the  letters  on  a  placard 
in  the  street. 

Silicea  18  ;    6  drops  to  6  ounces  of  water;  a  dessert-spoonful 
four  times  a  day. 
Jan.  30. — ^A  slight  cold,  with  slight  vascular  injection  of 
the  right  eye. 

Belladonna,  for  three  days. 
Feb.  6. — Much  the  same. 

Mer.  cor.,  for  six  days. 
Feb.  10. — ^Eyes  keep  improving. 

Gale,  acet  12. 
Feb.  16.— Going  on  welL 

Bepeat  the  Calc.  acet. 


with  Opacity  of  the  Cornea.  253 

Although  not  completely  recovered  this  case  is  one  of  the  most 
interesting  I  have  met  with  for  a  long  time.  The  cornea  of 
the  left  eye  is  very  nearly  transparent  throughout,  and  that  of  the 
right  eye  in  a  fair  way  towards  a  complete  cura  The  patient 
can  now  distinguish  the  lines  o£  impression  in  an  ordinary  book^ 
but  cannot  distinguish  the  letters. 

The  gentleman  who  attended  her  at  first  called  soon  after  I 
commenced  the  treatment,  tasted  the  medicine  she  was  taking, 
and  declaring  that  there  was  nothing  in  it ;  at  the  same  time  he 
announced  that  he  would  become  a  believer  in  Homoeopathy 
if  the  patient  ever  recovered  her  sight  by  means  of  it. 
Whether  he  ftdfilled  or  not  his  announcement  it  matters  but 
little,  at  any  rate,  this  is  certain,  that  notwithstanding  his  skill, 
neither  the  pain  nor  the  photophobia  were  relieved  by  the 
orthodox  measures  he  employed,  but  that  an  improvement  began 
soon  after  the  commencement  of  the  Homoeopathic  course,  and 
has  progressed  up  to  this  time  in  a  surprisingly  rapid  manner. 

On  looking  over  the  medicines  prescribed  in  these  cases  I  find 
that  Aconitum,  Belladonna,  and  Mercurius  Corrosivus  have  been 
those  almost  exclusively  employed.  In  one  case  Cannabis  sativa, 
and  in  two  Silicea. 

I  have  the  greatest  confidence  in  the  low  dilutions  of  the  three 
first  of  these  medicines  in  the  acute  cases  of  disease  of  the 
cornea,  followed  by  ulceration  and  subsequently  by  opacity, 
but  experience  has  taught  me  the  value  of  higher  dilutions  of 
Mercurus  corros.,  and  of  SUicea  in  the  more  chronic  forms.  The 
latter  medicines  I  prefer  usually  at  the  12th,  18th,  and  30th 
attenuations. 

In  cases  of  ophthalmia  of  a  more  violent  type,  with  more 
inflammatory  irritation,  and  in  strong  constitutions,  I  generally 
use  the  lowest  dilutions  of  Aconite  with  Belladonna,  and  Mercu- 
rius solubilis  in  preference  to  the  corrosive  sublimate.  The 
solubilis  is  conveniently  administered  on  the  2nd  or  3rd  decimal 
attenuations ;  th^  dose  a  grain  twice  or  three  times  a  day 
generally  alternated  with  Belladonna. 


254 


SOME  UNPUBLISHED  LETTEES  OF  HAHNEMANK 

To  Dr.  Stapf. 

Koethen,  August  5th,  1830. 

Dear  Friend  and  Colleague, 

The  accompanying  communication  is  for  the  meeting  of 
the  10th  of  August.  May  I  request  that  it  should  be  read 
slowly,  and  that  you  will  give  in  the  coming  Archiv,  -a  report 
of  the  Congress  along  with  this  paper  of  mine,  which  is  thus 
at  your  service  ? 

Will  you  also,  after  this  essay,  lay  before  the  meeting  this 
anonymous  communication,  which,  I  think,  wOl  be  of  use? 
there  will  be  those  present  who  will  understand  the  meaning 
of  it.  Joking  apart,  the  homoeopathic  physician  must  at  last 
come  to  this,  that  he  gives  only  the  needful  medicine  without 
any  vehicle ;  in  that  way  he  wiU  evade  aU  attempts  of  the 
criminal  jurisdiction  to  hinder  his  dispensing  his  own  medi- 
cines. Yours, 

Samxtel  Hahnemann. 

It  would  be  well  to  remind  the  meeting  that,  in  treating 
all  cases,  we  should  as  far  as  possible  ascertain  what  allo- 
pathic medicines  the  patients  have  taken  in  large  doses,  such 
as  sulphur,  carbonate  of  soda,  that  they  may  avoid  them. 

To  Dr.  Stapf. 

Koethen,  Dec.  27th,  1830. 
Dear  Friend  and  Colleague, 

I  send  you  with  this  one  globule  of  Natrum,  M.  30th, 
for  Miss  Eliza,  and  one  globule  of  Calcarea,  30th,  for  Miss  Mary, 
who,  however,  has  not  given  me  a  sufficiently  minute  account 
of  her  symptoms.     I  want  to  know  about  the  headache  last 


Unpublished  Letters  of  Hahnemann,  255 

week,  the  sleeping  of  the  limbs  and  the  whole  side,  the  sore 
throat,  the  hsemoptysfe,  and  cough,  as  well  as  the  swelling 
of  the  glands,  and  the  cold  feet.  The  next  time  she  writes,  I 
beg  she  will  be  more  particular  ;  however,  on  the  whole  I  am 
pleased  with  both. 

Dr.  E.  Aegidi  was  the  one  whom  I  also  preferred  for  the 
Princess.  I  thank  you  for  having  obtained  the  situation  for 
him. 

It  certainly  has  a  bad  appearance,  that  the  unequivocal  testir 
mony  in  the  journals  of  the  marvellous  efficacy  of  Homoeopathy 
(especially  Veratrum)  in  the  cholera  has  not  found  entrance  into 
the  ears  and  eyes  of  the  rulers,  particularly  Nickolus  ;  but  there 
is  no  doubt  that  it  must  ultimately  do  so.  The  great  and  infi- 
nitely good  Spirit,  who  cares  for  the  fate  of  the  lowest  insect, 
will,  with  mighty  hand,  in  the  stillness  of  His  power,  without 
our  being  able  to  see  how  all  co-operates  for  the  end,  take 
advantage  of  the  great  opportunity  which  so  directly  affects  the 
welfare  of  those  smitten  by  illness,  hitherto  so  sadly  neglected. 
The  present  system  of  medicine  is  really  a  disgraceful  patch- 
work. Eead,  for  example,  how  Hasper,  the  nephew  of  Kreysig, 
in  Leipsic,  in  the  face  of  the  Homoeopathists,  teaches  that  the 
cholera  should  be  treated  with  blood-letting  to  30  ozs.,  with 
leeches,  and  3  or  4  drachms  of  Calomel ;  grounding  this  mur- 
derous recommendation  upon  theory,  and  what  he  calls  the 
experience  of  the  best  physicians — ^that  is,  the  English.  Is  it 
not  enough  to  rouse  into  an  outbreak  the  rage  of  the  Homoeo- 
pathists ?  I  should  like  if  Attomyr  were  a  man  who  would 
raise  a  powerful  voice  against  the  allopathic  murders,  for  the 
reviews  of  allopathic  stuff  which  have  hitherto  appeared  in  your 
Archiv,  seem  to  me  to  be  done  with  too  lenient,  mild,  and  gentle 
a  hand,  to  shake  out  of  their  security  the  obdurate  and  scanda- 
lous blockheads.  For  such  a  case,  the  cautious,  timid  stroking 
of  our  homoeopathic  reviewers  won't  do ;  they  look  as  if  they 
were  going  to  attack  a  fly.  Can  it  be  worse  with  us  than  that 
we  shoxQd  be  deprived  of  our  natural  rights  as  citizens,  and  shall 


256  Unpvhlished  Letters  of  HahnemanrL 

we  not  scream  into  their  ears  the^  wrongs  they  do,  and  pursue 
the  murderous  host  with  stabs  of  our  only  weapon,  the  pen. 
They  must  learn  to  be  afraid  of  having  their  malpractice  attacked 
by  us ;  they  must  tremble  before  us,  otherwise  we  shall  make 
nothing  of  it,  and  our  immense  superiority  will  not  be  recog- 
nised ;  otherwise  we  shall  not  be  honoured,  nor  wiU  they  be 
brought  into  the  public  contempt  and  abhorrence  which 
they  so  richly  deserve.  I  must  beg  of  our  fellow-workmen 
to  rouse  them  better  for  the  work,  to  kindle  their  zeal, 
to  bring  into  clearer  light  the  advantage  of  our  heavenly 
art,  by  more  vigorous  defence  and  attack,  and  to  expose 
the  miserable  nakedness  of  these  men-slayers.  Were  I  but 
thirty  years  younger,  I  would  alone  engage  them,  and  none 
should  escape  my  deadly  strokes,  I  would  not  stop  till  I 
had  silenced  every  one  of  their  miserable  organs.  Now,  I 
ought  to  think  how  I  can  leave  this  duty  to  abler  disciples. 
After  I  have  finished  my  76th  year,  I  am  no  longer  able  to 
enter  the  ring.  I  have,  I  believe,  with  immense  efforts,  placed 
my  science  upon  pillars  which  can  never  be  overthrown.  But 
to  drive  the  haughty  and  slanderous  intruders  out  of  the  temple 
of  -^sculapius  with  scorpion  scourges,  less  will  not  suffice — 
ought  not  to  be  laid  upon  me.  Would  to  Gk)d  a  man  should 
arise  with  a  head,  a  heart,  and  powerful  arm,  who  would  devote 
his  Ufe  to  this  second  and  important  work  as  I  did  to  the  first 
— ^the  establishment  of  Homoeopathy !  Give  my  greeting  to 
Attomyr. 

I  send  you  along  with  this  the  Hungarian  translation  of 
the  "Organon"  and  the  first  part  of  my  "  Materia  Medica." 
For  GuiUon's  good  wishes,  thanks  from  my  whole  souL 

Up  let  us  raise  our  head.  If  we  do  not  conquer  and  beat  to 
the  ground  our  and  mankind's  enemies,  the  fault  is  ours ;  even 
now,  when  all  is  movement,  and  every  ear  and  eye  upon  the 
stretch,  it  is  the  time  to  begin  and  carry  something  through. 
My  spirit  is  with  you. 

Samuel  Hahnemann. 


Unpunished  Letters  of  Hahnemann.  257 

To  Dr.  Staff. 

Koetlien,  Feb,  3rd,  183L 

Dear  Friend  and  Colleague, 

Make  your  promise  good,  and  use  the  delightful  railway 
to  give  me  the  pleasure  of  a  visit ;  but  remember  you  must 
bring  our  friend  Eummel  along  with  you. 

So  you  will  not  wear  the  splendid  ring  ?  Are  there  not  true 
friends,  who  are  far  removed  from  envy,  and  who  rejoice  heartily 
and  truly  with  you  over  the  happy  circumstance  ?  Would  it 
be  well  to  deprive  such  friends  of  such  a  pleasure,  and  not  to 
show  them  this  gem  in  which  they  had  a  share.  I  feel  that  I  am 
such  a  friend  to  you,  for  a  gift  to  you  is  a  pleasure  to  me ;  and 
you  may  trust  that  there  are  many  of  the  same  sentiment.  So 
you  must  put  on  your  ring  when  you  go  to  visit  a  true  friend, 
that  you  may  rejoice  him  with  it.  And  yet  the  letter  the 
Duke  wrote  with  it,  is  worth  double  the  value  of  the  jewel ; 
but  this  excites  no  envy  in  your  friend,  but  gives  him  as  much 
gratification  as  if  the  letter  were  addressed  to  himself.  So  you 
may  know  how  to  act  in  such  a  case — and  you  will  put  on 
your  ring  for  the  sake  of  your  friend.  I  send  you  ^gidi's 
letter.  I  found  it  necessary  to  show  it  to  the  princess,  and  I 
have  done  him  good  service  by  so  doing ;  for  the  prince  imme- 
diately appointed  him  to  a  Hussar  regiment,  then  vacant,  under 
General  Von  Wiebel,  which  I  have  communicated  to  ^gidi.  I 
am  very  glad  of  this  piece  of  good  luck ;  for  besides  such  a 
post  in  so  populous  a  town,  under  the  protection  of  its  ruler, 
he  may  carry  on  his  homoeopathic  practice  without  let  or  hin- 
drance fix)m  any  man — preparing  and  distributing  his  medicines 
as  he  pleases.  If  this  is  not  incredible  good  fortune  for  a 
homoeopath,  I  know  not  what  is.  He  will  also  enjoy  the  favour 
of  the  princess,  although  I  continue  to  be  physician  to  her. 

I  have  only  had  time  within  these  few  hours  to  look  at  the 
new  number  of  the  Archiv,  which  you  were  kind  enough  to 
send  me.     The  article  of  Miiller,  the  only  one  I  have  read, 

17 


258  Lecture  by  Dr.  Russell  on  Epilepsy, 

speaks  of  me  in  such  a  tone,  that  I  must  shortly  write  him  a 
letter  of  acknowledgment.  Thus  must  we  step  out,  imless  we 
are  to  be  prepared  to  be  trodden  to  pieces.  He  has  won  great 
creat  credit  to  himself  by  this  article.     Do  you  know  anything 

of ?  I  hear  nothing.      Hermann,  of  Petersburg,  who  had 

to  do  with  his  family,  writes  to  me  without  being  asked,  that 
he  is  a  pitiable  shaking  reed.  I  do  not  know  how  better  I 
can  say  it.  Hermann  has  just  married  my  neice,  the  youngest 
daughter  of  Trinius,  of  the  Academy. 

Yours,  Samuel  Hahnemann. 


^    /»r  LECTUEE  ON  EPILEPSY.— Lecture  II. 

By  De.  RusslELL. 
Gentlemen, 

I  propose  in  this  lecture  to  confine  my  observations  to 
the  treatment  of  Epilepsy.  The  success  hitherto  obtained 
by  the  most  careful  and  scientific  practitioners,  accord- 
ing to  the  old  school-method,  has  been  very  xmsatisfactory. 
Out  of  115  cases  of  chronic  convulsive  diseases  treated  by 
Dr.  Reynolds,  all  of  which  in  common  parlance  would  have 
been  entitled  Epilepsy,  and  had  been  treated  as  such  for  many 
years,  21,  or  18  per  cent,  were  cured.  Of  these,  however 
only  80  were  true  Epilepsy,  and  the  number  of  recoveries  out 
of  these  80  were  only  8,  or  10  per  cent.  Out  of  191  cases 
treated  in  this  Hospital,  38  are  reported  as  cured,  or  20  per 
cent.  But  as  these  cases  are  chiefly  among  the  out-patients 
there  is  always  considerable  uncertainty  in  regard  to  the  re- 
sults in  a  disease  which  may  be  long  dormant  without  being 
radically  cured.  And  under  the  head  Epilepsy,  it  is  not  iln- 
probable  that  other  forms  of  convulsive  diseases  may  have 
been  included,   as  in  Dr.  Reynolds's  first  list.      There  is  no 


Lecture  by  Dr.  Russell  on  Epilepsy,  259 

great  difference  in  the  results,  judging  by  these  tables  of  the 
old  and  new  system.  At  all  events,  whether  we  excel  our 
neighbours  or  not,  we  have  no  ground  to  boast.  So  long  as  we 
have  to  record  the  mortifying  fact,  that  four-fifths  of  the  epi- 
leptic patients  who  have  been  treated  by  us  have  not  been 
cured;  and  if  any  one  can  discover  more  certain  indications 
for  the  remedies  most  commonly  used,  or  suggest  any  means 
not  hitherto  employed,  and  which  hold  out  any  prospect  of 
advantage,  he  will  be  hailed  as  a  benefactor  of  his  kind. 

In  considering  the  treatment  of  EpUepsy,  the  subject  na- 
turally divides  itself  into  general  rules  for  the  guidance  of 
patients,  so  that  they  may  be  fortified  against  the  consequences 
of  the  disease,  and  the  special  indications  for  the  administra- 
tion of  remedies. 

In  regard  to  the  first,  or  the  general  management  of  epileptic 
patients,  there  is  a  great  difference  of  opinion  as  to  the  proper 
food;  one  party  strongly  advocating  a  low  diet,  excluding 
animal  food  and  forbidding  all  stimulants ;  while  another  party 
insists  upon  what  is  called  a  generous  fare  and  a  liberal  allow- 
ance of  wine.  Those  who  adopt  the  latter  view,  argue  that  we 
are  apt  to  be  deceived  into  the  erroneous  idea  of  spasms  being  a 
manifestation  of  excessive  nervous  force ;  while,  on  the  contrary, 
their  presence  invariably  indicates  an  enfeebled  condition  of  the 
nervous  system ; — that  we  meet  with  them  as  consequences  of 
loss  of  blood  and  of  impaired  vigour  generally,  and  that  the 
restlessness  of  a  nervous  patient  is  not  from  too  much,  but 
from,  too  little  life.  Especially  it  is  pointed  out,  that  the 
scanty  vitality  of  epUeptics  is  betrayed  by  the  general  coldness 
of  the  extremities,  and  the  small,  quick,  and  jerking  pulse. 
And  that  it  is  in  consequence  of  this  low  condition  of  what 
we  may  call  the  power  of  the  Anima,  that  persons  afflicted 
with  Epilepsy  become  subject  to  cosmical  influence.  That,  in 
fact,  they  approach  the  life  of  plants  as  they  recede  from  that 
of  man.  "  The  plant,"  says  Dr.  Eadcliife  [Epilepsy  and  other 
Conytdsive  Affections.    By  Charles  Bland  Eadcliffe,  M.D.     2nd 


260  Lecture  hy  Dr,  Russell  on  Epilepsy, 

ed.,  1858,  p.  142],  "  exhibits  plainer  and  more  numerous  evi- 
dences of  periodicity  than  the  animal ;  and  it  does  this,  I  argue, 
because  it  has  less  of  the  innate  life  which  enables  man  and  the 
higher  animals  to  be  partially  independent  of  the  sun  and  other 
vivifying  influences  which  act  upon  them  from  without ;  and 
hence  it  follows  (this  among  other  reasons)  that  the  man  who 
exhibits  more  evidences  of  periodicity  than  he  ought  to  do, 
has  been  shorn  of  some  of  that  innate  life  which  is  the  badge 
of  destinction  between  him  and  the  plant."  Whether  or  not  the 
want  of  the  power  of  the  Anima  brings  the  epileptic  under  the 
influence  of  the  moon,  has  been  keenly  debated,  and  some  of 
our  most  recent  and  most  scientific  writers  declare  themselves 
on  the  side  of  the  moon.  "  Although  here  and  there,"  observes 
Eomberg  [vol.  ii.  p.,  205],  "doubts  have  been  raised  against 
this  view,  the  accurate  observations  of  others  have  estabhshed 
its  correctness."  Among  these  observers  a  prominent  place  is 
always  given  to  Dr.  Mead,  who,  in  the  following  words,  de- 
scribes a  celebrated  case  of  lunar  influence.  "  No  greater  con- 
sent in  such  cases  was,  perhaps,  ever  observed  than  what  I  saw 
many  years  since,  in  a  child  about  five  years  old,  in  which  the 
convulsions  were  so  strong  and  frequent,  that  life  was  almost 
despaired  of.  .  .  .  The  girl,  who  was  of  a  lusty,  full  habit  of 
body,  continued  well  for  a  few  days,  but  was,  at  full  moon, 
again  seized  with  a  most  violent  fit ;  after  which  the  disease 
kept  its  period  constant  and  regular  with  the  tides.  She  lay 
always  speechless  during  the  whole  time  of  flood,  and  recovered 
upon  the  ebb.  The  father,  who  lived  by  the  Thames  side,  and 
tiid  business  upon  the  river,  observed  these  returns  to  be  so 
punctual,  that  not  only  coming  home,  he  knew  how  the  child 
was  before  he  saw  it;  but  in  the  night  has  risen  to  his 
employ,  being  warned  by  her  cries,  when  coming  out  of  the  fit, 
of  the  turning  of  the  water.  This  continued  fourteen  days — 
that  is,  to  the  next  change  of  the  moon."  This  case  is  gene- 
rally quoted  as  demonstrative  proof  of  the  moon's  power. 
Perhaps  it  would  be  more  correct  to  accept  it  as  evidence  of 


Lecture  by  Dr,  Russell  on  Epilepsy,  261 

general  cosmical  influence,  for  it  may  have  been,  that  it  was  not 
any  direct  effect  of  the  moon  upon  the  nervous  system  of  this 
child,  but  of  the  ebbing  and  flowing  of  the  waters  of  the 
Thames^  We  now  know  that  it  is  held  by  some  of  our  highest 
authorities,  that  the  molten  lava  which  underlies  the  habitable 
crust  of  the  globe — ^the  waters  of  fire  under  the  earth — flow 
and  ebb  in  their  outlets — the  volcanoes,  just  as  the  waters  of 
the  ocean  above  the  earth,  swell  and  retire  in  obedience  to 
tidal  laws. 

How  much  we  are  all  under  cosmical  influences,  is  every 
now  and  then  shown,  when  an  earthquake  happens,  or  a 
new  epidemic  sweeps  over  a  tract  of  a  country,  cutting  down, 
as  with  a  scythe,  all  who  have  not  enough  of  vital  power  in 
them  to  resist  its  fatal  force.  The  weak  perish,  but  all,  even 
the  strongest  are  affected.  The  most  sensitive  are  aware  of  it 
at  the  greatest  distance.  A  curious  illustration  of  this  is  men- 
tioned in  Eckermann's  Conversations  with  the  Poet  Goethe, 
who,  although  one  of  the  most  sensitive,  was,  at  the  same  time, 
one  of  the  most  robust  of  men — a  great  example  of  that  rare 
nature,  which,  like  our  own  Shakespeare,  felt  everything,  and 
was  subdued  by  nothing.  One  night  Goethe  rang  for  his  ser- 
vant about  midnight ;  when  the  servant  went  he  found  that 
Goethe  had  moved  his  bed  to  the  window  and  was  gazing  upon 
the  heavens.  Goethe  asked  him  if  he  had  seen  nothing  re- 
markable in  the  sky ;  on  receiving  an  answer  in  the  negative, 
he  desired  the  man  to  enquire  of  the  watchmen  if  they  had. 
They  had  not.  On  his  servant's  return  he  found  his  master 
still  in  the  same  position,  and  he  made  this  remarkable  an- 
noimcement:  "Listen,"  said  Goethe,  "this  is  an  important  mo- 
ment, there  is  now  an  earthquake,  or  one  just  going  to  take 
place."  Next  day  he  mentioned  at  Court  (Weimar)  his  con- 
viction, and  the  duke  believed  he  was  right,  from  his  know- 
ledge of  Goethe's  character.  Some  weeks  afterwards  the  in- 
telligence arrived  at  Weimar  that  upon  that  night  the  great 
earthquake  had  taken  place  at  Messina,  which  had  overthrown 


262  Lecture  hy  Dr.  Russell  on  Epilepsy. 

a  great  part  of  that  city.  Here  we  have  an  example  of  an 
impressionable  man  perceiving  a  telluric  influence  unfelt  by  his 
fellows.  He  perceived  it,  but  merely  as  a  sensation,  from 
which  he  drew  his  inferences ;  for  his  nervous  system  was  in  a 
state  of  health.  But  if  it  had  been  in  an  epileptic  condition, 
would  this  impression  not  have  most  Kkely  given  rise  to  a  fit  ? 
We  have  positive  proof  afforded  by  the  experiments  of  Dr. 
Brown-S^quard,  that,  while  on  the  one  hand  an  injury  of  the 
centre  of  the  nervous  system  is  a  predisposing  cause  of  Epil- 
epsy, that  on  the  other  hand  the  exciting  cause  is  an  impres- 
sion on  the  extremities  of  the  nerves  in  communication  with 
this  morbid  centre,  and  that  so  long  as  this  part  of  the  peri- 
phery is  not  affected,  the  Epilepsy  may  slumber'  for  almost  any 
length  of  time. 

The  most  important  general  indications  in  the  treatment  of 
Epilepsy  are  discovering  how,  in  each  case,  the  strength  of 
the  patient  can  be  best  sustained.  Some  thrive  best  on  a 
nearly  purely  animal  diet;  some  on  a  merely  vegetable  one; 
others  on  a  mixture  of  the  two.  We  must  find  out  by  careful 
investigation,  which  agrees  best,  and  that  we  must  order.  The 
same  rule  holds  good  as  regards  stimulants ;  to  some  they  are 
injurious,  to  some  beneficial,  and  to  others  indifferent.  The  great 
error  seems  to  be,  laying  down  any  general  rule  for  Epileptic 
patients.  There  is,  and  can  be,  no  such  rule.  Each  case  must 
be  treated  on  its  own  merits,  and  diet  should  be  as  specific  as 
treatment.  It  is  a  consequence  of 'this  vague  generalization, 
that  it  is  the  fashion  to  order  iron,  and^^so  called  tonics,  in 
Epilepsy.  The  pmctice,  although  recommended  by  so  high  an 
authority  as  Dr.  Watson,  is  emphatically  condemned  by  Dr. 
Brown-S^quard.  The  action  of  iron  on  the  brain  he  considers 
injurious.  The  same  rule,  or  rather  the  same  latitude  and 
absence  of  rule,  which  directs  us  best  in  i-egard  to  diet,  would 
be  good  in  respect  of  exercise,  and  indeed  of  every  one  of  the 
conditions  of  healtL  In  a  case  of  Epilepsy,  we  must  carefully 
examine  into  all  the  habits  of  the  patient,  and  insist  upon  the 


Lecture  ly  Br,  Rtossell  on  Epilepsy,  263 

avoidence  of  everything  which  can  either  damage  or  enfeeble 
the  general  health,  and  tend  to  give  special  animation  to  any 
exciting  cause  of  a  paroxysm.  Above  all  things,  we  should 
have  the  patient  avoid  all  sources  of  irritation  of  the  surface  of 
the  body,  being  taught  by  physiology  how  the  sensitiveness 
of  the  peripheral  nerves  is  exalted  by  the  epileptic  condition ; 
and  it  is  rational  to  expect  benefit  from  soothing  ablution  with 
cold  or  hot  water,  and  the  application  of  soap  or  oil  to  the 
surface  of  the  body.  The  effect  of  soap-water — a  common  ex- 
pedient in  the  water-cure  establishments — in  relieving  an  over- 
sensitive condition  of  the  skin,  is  most  marked,  and  may  be  of 
great  use  in  the  treatment  of  Epilepsy.  What  an  Epileptic 
wants  is  strength  within  and  hardness  without.  The  great 
source  of  inward  strength  is  food  and  exercise,  and  of  outward, 
hardening  friction  and  proper  baths.  If  we  can  discover  any 
particular  spot  where  the  aura  (if  there  is  an  aura)  takes  its 
rise,  we  may  be  tempted  to  try  the  effect  of  a  local  anaesthetic 
upon  it.  The  best  is  probably  that  recommended  by  Dr. 
Brown-S^quard,  and  consists  of  half-a-grain  of  Sulphate  of 
Morphia,  and  one-sixtieth  of  Sulphate  of  Atropia,  and  a  minim 
of  dilute  Sulphuric  Acid  in  fifteen  minims  of  water.  This  is 
to  be  injected  under  the  skin  of  the  part  where  the  aura  origi- 
nates. 

It  is  now  clearly  established  that  weakness  of  a  muscle,  or 
set  of  muscles,  predisposes  it  to  be  affected  with  spasmodic 
action.  Dr.  Brown-S^quard,  in  a  lecture  recently  delivered  in 
this  neighbourhood,  and  reported  in  the  Medical  Times  and 
Qaaette  of  March  28th,  observed  that  "of  two  muscles,  one 
atrophied  and  one  healthy,  the  former  will  respond  to  a  cer- 
tain stimulant,  while  the  latter  will  not ;  a  weak  person  will 
jump  or  start  on  hearing  a  noise,  which  produces  no  effect  upon 
a  strong  one."  This  he  attributes  not  to  "  weakness  of  nerves," 
as  it.  is  called,  but  to  the  weakness  of  the  muscles.  Epileptics 
are  usually  very  weak,  often  partially  paralysed ;  their  reflex 
excitability  is    augmented,   while   their   voluntary    muscular 


264  Lecture  hi/  Dr,  Russell  on  Epilepsy. 

power  is  diminishei  Here,  then,  we  have  one  of  the  most 
important  of  the  general  indications  for  ti^atment — yiz.,  the 
adoption  of  means  to  increase  the  voluntary  power  of  the 
muscles.  Nothing  is  better  for  this  than  gentle  drilling,  or  a 
course  of  what  is  called  medical  gymnastics.  I  have  known 
cases  of  Epilepsy  very  much  benefited  by  the  treatment 
known  by  the  name  of  "  the  Movement  Cure." 

To  sum-up,  an  epileptic  patient  should  be  nourished  with 
the  greatest  care,  so  as  to  bring  the  whole  body  into  the  highest 
condition,  but  especial  attention  should  be  paid  to  the  develop- 
ment of  the  muscular  system,  and  this  should  be  exercised  in 
such  a  way  as  to  improve  the  control  over  the  limbs.  Thus, 
dancing,  marching,  and  all  movements  which  tend  to  curb  the 
loose  shambling  gait  of  the  epileptic,  are  of  importance  to  his 
cure.  Besides,  great  care  sHbtild  be  bestowed  in  bringing  the 
skin  into  a  healthy  state,  by  baths  and  by  friction,  'so  as  to 
allay  all  morbid  sensitiveness,  which  is  apt  to  be  the  starting 
point  of  the  train  of  mischief,  which  ends  in  a  paroxysm. 
These  are  the  obvious  suggestions  made  by  common  sense  upon 
the  facts  ascertained  by  modem  physiology,  in  regard  to  the 
causes  of  EpUepsy ;  at  the  same  time  it  is  right  that  we  should 
bear  in  mind  that  we  ^hall  often  meet  with  epileptics  who 
are  in  perfect  bodily  health,  and  well  developed.  Dr.  Eeynolds 
lays  down  as  inferences  from  a  large  series  of  observations : — 

That  Epilepsy  is  not  incompatible  with  perfect  physical 
health. 

That  it  is  the  exception,  not  the  rule,  to  find  serious  impair- 
ment of  the  organic  constitution. 

That  the  co-existence  of  Epilepsy  with  extremely  robust 
health,  is  more  common  than  the  converse. 

How  far  Dr.  Eeynold's  observations  justify  such  sweeping  con- 
clusions I  cannot  say,  but  certainly  several  of  the  cases  that  have 
come  under  my  own  treatment  have  been  persoHS  in  whom  I 
never  should  have  suspected  any  infirmity  of  any  kind,  judg- 
ing from  their  appearance.;  and  in  this  class  of  patients  we 


Lecture  hy  Dr.  Russell  on  Epilepsy,  265 

cannot  expect  to  do  miicli  good  by  any  general,  dietetic,  or 
regeninal  management,  and  must  confine  our  expectations  to 
producing  a  change  in  the  system  of  the  patient  by  a  st.eady 
course  of  medical  treatment. 

The  treatment  of  Epilepsy  by  medicines  naturally  divides 
itself  into  those  which  are  best  adapted  to  arrest  the  first 
stage,  and  those  which  tend  to  mitigate  the  paroxysms,  and 
prolong  the  interval  between  the  attacks. 

There  seems  no  doubt  that  the  first  stage  of  an  epileptic 
seizure  may  be  arrested,  just  as  the  first  stage  of  Cholera  is,  by 
Camphor.  I  have  witnessed  this  in  Cholera.  I  once  saw  a 
little  girl  of  about  eight  years  of  age  literally  take  Cholera. 
She  was  in  a  room  where  there  were  two  patients  in  a  state  of 
collapse.  She  suddenly  gave  a  slight  cry,  and  on  looking  at 
her  face  I  saw  the  immistakeable,  but  indescribable  change, 
which  indicates  the  invasion  of  Cholera.  This  is  a  well-known 
fact  in  regard  to  Cholera.  In  the  instance  referred  to,  I  im- 
mediately gave  the  patient  a  dose  of  Camphor  which  I  had  in 
my  hand.  The  effect  was  instantaneous.  I  watched  th^  life 
returning  into  the  face,  which  before  had  been  the  countenance 
of  a  corpse.  It  came  back  slowly  and  steadily,  the  pulse  was 
extremely  rapid  and  small ;  it  increased  in  volume,  and  abated  in 
speed,  and"  in  about  ten  minutes  the  danger  of  death  was  passed. 
The  same  rapid  arrest  of  an  epileptic  paroxysm  is  sometimes 
effected.  "  Once,"  says  Dr.  Eeynolds,  "  when  I  was  talking  to 
an  epileptic;  and  observing  his  eye,  a  fit  commenced ;  the  eyes 
rolled  upwards,  and  to  one  side,  and  the  pupils  dilated.  He 
had,  however,  after  this  dilatation  sufficient  power  to  say,  "  I  am 
going  to  be  ill,"  but  not  till  then  did  the  distortion  begin. 
This  attack  was  stopped  by  Chloroform.  Similar  attacks  in 
other  patients  have  been  arrested  by  placing  Ammonia  near 
the  nostrils.  But  neither  Ammonia,  or  Chloroform  or  anything 
else,  has  the  slightest  effect  after  the  first  moment  of  the 
paroxysm. 

This  first  stage  of  Epilepsy  is  probably  caused  by  contrac- 


266  Lecture  h/  Dr.  Russell  on  Epilepsy, 

tion  of  the  blood  vessels  of  the  brain  proper,  and  of  the  face, 
and  tonic  spasm  of  the  muscles  of  the  eye  and  face.  The  effect 
of  Ammonia  and  Chloroform  upon  this  spasm  is  very  much 
like  that  of  the  smoke  of  Strammonium  upon  the  asthmatic 
spasm,  and  immediate  relief  is  the  consequence.  Considering 
that  upon  the  arrest  of  this  first  stage  so  much  depends,  and 
that  in  some  respects  it  is  so  easily  managed,  it  seems  singular 
that  it  should  so  seldom  be  effected.  The  reason  is,  that  this 
stage  is  so  very  short,  lasting  not  above  a  few  seconds,  and 
that  even  these  few  seconds  have  somewhat  deprived  the 
epileptic  person  of  his  power  of  thought  and  action.  It  is 
just  possible  that  there  may  have  been  real  virtue  in  some  of 
the  amulets  that  were  so  highly  prized  even  by  the  least  super- 
stitious of  the  ancient  physicians  in  the  treatment  of  Epilepsy. 
Possibly  certain  substances  worn  round  the  neck,  so  as  to  give 
off  their  fragrant  or  pungent  particles  in  the  immediate  neigh- 
bourhood of  the  extremities  of  the  branches  of  the  nerves  that 
supply  the  lips  and  nostrils  may  have  had  a  good  effect  in 
arresting  the  first  stage  of  Epilepsy;  and  it  may  be  worth 
while  to  try  the  effect  of  a  bag  of  Camphor  suspended  round 
the  neck,  such  as  it  was  the  custom  for  persons  exposed  to  Cholera 
contagion,  to  wear. 

If,  however,  our  efforts  to  arrest  the  first  stage  fail — and  for 
my  own  part,  I  have  never  seen  them  succeed — then  we  must 
address  ourselves  to  the  task  of  discovering  some  medicines 
which  so  act  upon  the  seat  of  the  disease  as  to  restore  it  to 
a  normal  condition,  that  is,  which  have  the  power  of  reducing 
to  their  natural  calibre  the  capillaries  of  the  spinal  chord  and 
brain,  and  thus  of  removing  that  preternatural  excitability, 
on  which  it  now  seems  pretty  certain  that  EpUepsy  depends. 

On  entering  upon  this  the  most  important  and  most  diflficul* 
portion  of  our  task,  it  is  well  that  we  should  clearly  perceive 
on  what  the  difficulty  depends.  It  arises  in  a  great  measure 
from  the  conflicting  testimony  in  regard  to  the  efficacy  of  par- 


Lecture  by  Dr.  Russell  on  Epilepsy,  267 

ticular  substances,  a  difficulty  always  great  in  medicine,  but  un- 
usually so  in  a  disease  like  Epilepsy,  which  is  so  uncertain  in 
its  course  as  to  baffle  the  most  careful  efforts  of  the  least 
unbiassed  to  arrive  at  positive  evidence  in  regard  to  the 
utility  of  any  given  drug.  When  we  read  the  works  of  recent 
writers  we  are  struck  with  the  acumen  they  display  in  their 
critical  demolition  of  the  statements  of  their  predecessors  and 
contemporaries.  For  example.  Dr.  Eadcliflfe  analises  Trouseau's 
cases  cured  by  Belladonna,  and  reduces  the  number  to  20  out 
of  the  150  patients  treated.  From  Dr.  Eadclifife  we  expect 
some  statement  of  his  own  success  which  shall  be  unassailable 
by  the  process  he  brings  to  bear  upon  Trouseau.  Dr.  Eadclifife 
is  an  advocate  for  the  employment  of  Naphtha,  Musk,  and 
Castor,  and  we  eagerly  look  for  the  proofs  of  his  confidence. 
What  does  he  give  us  ?  "I  think,  he  says,  also,  I  can  point  to 
at  least  a  score  of  cases  in  which  the  fits  have  not  only  been 
lessened  in  severity  by  being  deprived  of  their  most  ominous 
character — Coma;  but  where  the  intervals  between  the  fits 
have  become  so  lengthened  out  as  to  aflford  good  ground  for 
supposing  that  the  fatal  habit  may  be  altogether  broken  by  a 
continuance  of  the  same  method."  If  Trouseau,  instead  of  a 
detailed  account  of  all  the  150  cases  which  he  had  treated 
with  Belladonna,  had  said  he  thought  he  could  point  to  some 
scores  of  patients  who  had  been  benefited  by  this  remedy,  how 
mercilessly  would  Dr.  Eadclifife  have  commented  upon  the  dif- 
ference of  Trouseau's  thoughts  or  impressions,  and  the  pos- 
sitive  testimony  demanded  by  science  before  she  can  adopt  the 
conclusion  that  Belladonna  was  the  real  instrument  of  cure ! 

I  do  not  make  these  observations  to  discredit  Dr.  Eadclifife, 
for  whose  labours  I  entertain  the  highest  respect,  but  to  show 
how  miich  easier  it  is  to  attack  the  positions  of  another  than 
to  place  one's  own  so  as  to  secure  them  from  being  taken 
by  a  similar  assault. 

What  we  observe  in  regard  to  the  therapeutics  of  Epilepsy 
is  one  of  two  courses,  either  an  empirical  confidence  in  certain 


268  Lecture  hy  Dr.  Riissell  on  Epilepsy, 

remedies  without  a  corresponding  pathological  collateral  security, 
or  conjectural  measures  derived  from  inferences  drawn  from 
pathological  speculations,  and  as  yet  unsubstantiated  by  the  suc- 
cessful adaptation  of  these  hypothesis  into  actual  practice. 

Nor  are  these  obscuring  conditions  peculiar  to  either  the  old 
or  the  new  school  of  medicine.  For  example — on  the  occasion 
of  a  paper  being  read  before  the  Medico-Chirurgical  Society, 
Sir  Charles  Locock  (the  President)  remarked  that  in  Epilepsy, 
in  which  the  paroxysm  had  a  tendency  to  assume  a  periodic 
character  connected  with  menstruation,  he  had  been  led  to  try 
the  Bromide  of  Potassium,  by  an  observation  made  by  a  German 
physician  that  this  medicine  produced  temporary  impotence. 

Sir  Charles  stated  that  he  had  treated  fourteen  or  fifteen 
cases  of  Epilepsy  presenting  this  peculiarity  with  Bromide 
of  Potassium,  and  that  he  had  only  failed  to  give  relief  in  one 
case ;  and  that  one  of  the  cases  so  cured  had  lasted  nine  years. 
[Medico  Chirurgical  Transactions  for  1857.] 

T  call  this  an  example  of  an  empirical  cure ;  for  we  cannot 
admit,  that  because  a  German  physician  observed  impotency  to 
follow  the  administration  of  Bromide  of  Potassium,  that  therefore 
this  substance  was  specifically  adapted  for  the  treatment  of  what 
may  be  called  Catamenial  Epilepsy.  However,  as  an  empiri- 
cal remedy  it  may  be  worthy  of  our  attention,  and  the  fact 
that  so  accurate  an  observer  as  Sir  C.  Locock  testifies  to  its 
utility,  is  certainly  a  strong  recommendation  to  examine  its 
claims  by  the  light  of  our  therapeutic  law.  As  yet  we  have 
not  such  a  proving  of  the  Bromide  of  Potassium  as  to  enable  us 
to  put  it  to  this  test.  Other  examples  of  purely  empirical  reme- 
dies resorted  to  largely  by  the  practitioners  of  the  old  school  of 
medicine  (which  affects  such  pharisaical  contempt  for  the  means 
it  so  frequently  condescends  to  employ,  are  the  following: — . 

Viscus  Quercinus,  or  Mistletoe,  [On  Epilepsy  and  the  use 
of  Viscus  Quercinus,  by  Henry  Eraser,  M.D.]  Cotyledon  Um- 
bilicus, and  Indigo. 

Of   Viscus    Quercinus,  Dr.    Eraser  reports  that  out  of  11 


Lecture  ly  Dr.  Russell  on  Epilepsy,  269 

cases  of  Epilepsy  which  he  treated  with  this  substance  9  were 
cured,  one  was  moribund  and  one  died. 

Indigo  was  employed  in  Epilepsy  first  by  Dr.  Ideler,  of 
Berlin,  and  subsequently  by  Dr.  Eodrigues  (Eevue  Medicale, 
April,  1855).  It  is  rather  remarkable  that  although  Indigo  is  a 
remedy  introduced  into  the  Homoeopathic  therapeutics,  it  should 
not  be  included  in  the  list  of  medicines  which  Dr.  Laurie  gives 
as  suitable  for  the  treatment  of  the  various  forms  of  the 
disease — although  this  list  embraces  no  less  than  46  of  our  me- 
dicines. Certainly  the  chapter  on  Epilepsy  in  Laurie's  "  Elements 
of  the  Homoeopathic  practice  of  Physic,"  must  impress  our  old 
school  medical  colleagues  with  the  enviable  richness  of  our  re- 
sources ;  and  at  the  same  time  excite  a  wholesome  respect  in 
the  minds  of  laymen  for  any  human  intelligence  which  knows 
how  to  use  as  arms  of  precision  nearly  half  a  hundred  dif- 
ferent weapons. 

Cotyledon  umbilicus,  like  the  two  former  substances,  has  its 
admirers  and  defenders.  It,  too,  has  been  "  proved"  by  one  of 
our  body.  But  the  proving  has  not  induced  its  reception  as 
one  of  the  accredited  Homoeopathic  remedies. 

I  have  now  given  illustrations  of  the  empirical  remedies 
recommended  by  high  authorities  in  the  old  school, — simply  on 
the  ground  of  their  approved  usefulness.  If  this  were  ad- 
mitted, then  we  should  not  cavil  at  the  absence  of  a  satisfac- 
tory explanation  of  their  mode  of  operations.  But  unfortunately 
there  is  not  one  of  the  specifics  in  vogue  for  the  treatment  of 
Epilepsy,  that  has  not  a  much  larger  number  of  deniers  than 
of  believers,  and  as  the  number  of  such  specifics  is  so  numer- 
ous, that  their  bare  enumeration  would  fill  a  respectable  vo- 
lume, it  is  clearly  hopeless  to  attempt  by  the  simple  empirical 
method  of  experiment,  unguided  by  theory,  to  determine 
whether  any  of  them  have  really  the  virtues  with  which  they 
have  been  accredited.  Nor  is  there  better  chance  of  success,  if 
we  pursue  the  opposite  method,  and,  if  having  accepted  the 
pathological  doctrines  now  in  fashion  as  the  basis  of  our  treat- 


270  Lecture  hy  Dr.  Ru$sell  on  Epilepsy, 

ment,  we  administer  medicines  in  obedience  to  them  alone ; 
for  the  whole  history  of  medicine,  if  it  shows  anything,  proves 
this — that  every  age  supposed  it  had  arrived  at  the  long- 
coveted  knowledge  of  the  real  and  essential  cause  of  disease. 
Now  it  is  a  poison,  formerly  it  was  a  spasm,  and  against  the 
spasm  an  anti-spasmodic  was  prescribed,  and  after  the  world 
had  been  on  the  strength  of  this  doctrine  swallowing  anti- 
spasmodics for  a  quarter  of  a  century,  up  rose  some  clever, 
bold  man,  who  denied  with  such  force,  and  argued  with  such 
cogency,  against  the  notion  of  a  spasm  having  anything  to  do 
with  the  matter — that  the  world  voted  itself  in  the  wrong,  and 
gave  up  taking  any  more  anti-spasmodics.  There  seems  a 
danger  of  our  falling  again  into  this  error.  The  observations  of 
anatomists  and  physiologists  in  regard  to  Epilepsy  are  very 
important,  and  their  speculations  as  to  its  cause  very  ingenious, 
and  possibly  true.  But  let  us  remember  that  there  is  no  theory 
which  lias  yet  been  universally  received  by  all  physiologists, 
and  that  the  most  approved  at  present  has  not  stood  the  test 
of  twenty  years ;  while  on  the  other  hand  the  symptoms  of 
Epilepsy  have  been  carefully  noted  for  as  many  centuries,  and 
if  we  acknowledge  the  sufficiency  of  our  therapeutic  maxim 
as  a  guide  in  other  diseases,  there  is  no  reason  why  we  should 
discard  it  here.  Let  us,  then,  not  be  led  astray  from  the  study 
of  the  symptoms  of  Epilepsy  into  the  speculative  region  of  the 
cause  of  these  symptoms.  At  the  same  time  let  us  carefully 
arrange  these  symptoms,  so  as  show  at  once  both  their  natural 
sequence  and  their  comparative  importance,  and  then  try 
whether  we  can  exhibit  any  medicinal  actions  having  a  similar 
sequence,  producing  similar  results,  and  if  so,  whether  the  sub- 
stances that  do  so  ever  cure  Epilepsy. 

In  limine,  let  us  observe  that  any  medicine  which  is  to 
affect  a  radical  change  in  the  condition  of  an  Epileptic  nervous 
system,  and  not  merely  arrest  the  propagation  of  the  exciting 
cause,  must  be  one  endowed  with  powers  of  long  duration. 
For  this  reason,  I  do  not  believe  in  the  cures  of  Epilepsy  said 


Lecture  hy  Dr,  Russell  on  Epilepsy,    *  271 

to  be  effected  by  Musk  and  Castor,  and  science  demands  of 
Dr.  Eadcliffe  something  more  exact  and  definite  than  his  state- 
ment to  the  effect,  that  he  could  point  out,  at  least,  a  score  of 
cases  which  had  been  practically  cured  by  these  fugitive 
remedies. 

Let  us  now  arrange  the  symptoms  in  the  order  of  their  oc- 
currence, putting  down  only  the  invariable,  which  we  may 
presume  to  be  the  essentiaL 

1.  Dilatation  of  the  pupil  of  both  eyes. 

This  takes  place  lefore  there  is  any  loss  of  consciousness,  and 
is  therefore  not  dependent  upon  general  insensibility. 

2.  Paleness  of  the  face. 

3.  Twitches  of  the  muscles  of  the  eyes  and  face. 

4.  Loss  of  consciousness. 

5.  Tonic    contraction    of  the    laryngeal  and     expiratory 
muscles. 

6.  Cry. 

T.  Tonic  contractions  of  the  muscles  of  the  trunk  and  limbs. 

8.  FalL 

9;  Dark  purple  hue  of  the  face. 

10.  Asphyxia. 

11.  Clonic  convulsions  everywhere. 

12.  Coma. 

13.  Sleep. 

We  have  no  right,  on  the  Homoeopathic  principle,  to  expect 
any  medicine  to  be  effectual  in  the  cure  of  Epilepsy,  unless  its 
pathogenesy  covers  all  these  symptoms.  But  this  is  not 
enough — it  must  also  be  capable  of  inducing  a  permanent 
derangement  of  the  functions  of  the  brain  and  other  parts  of 
the  nervous  system,  as  indicated  by  some  impairment  of 
memory  and  apprehension,  by  a  tendency  to  muscular  feeble- 
ness, and  by  a  general  habit  of  slight  spasmodic  action,  repre- 
sented by  a  the  "  starts,"  faintness,  momentary  arrest  of  con- 
sciousness, &c,  which  constitute  the  most  important  inter- 
paioxysmal  phenomena.     We  should  also  like  to  find,  in  our 


272  Lecture  hy  Dr.  Russell  on  Epilepsy. 

medicine,  the  power  of  producing  somnambulism,  which,  as  we 
have  seen,  has  a  strong  resemblance  with  some  well-marked 
Epileptic  conditions. 

Let  us  now  examine  by  the  proposed  tests  our  Homoeopathic 
medicines.  Balladonna  fulfils  the  first  condition  we  have 
laid  down  as  essential  It  is  a  medicine  of  long  enduring 
action.  On  this  head  Hahnemann  observes : — "In  the  smallest 
imaginable  dose,  when  the  symptoms  of  the  disease  make 
Belladonna  the  suitable  remedy,  it  proves  curative  in  the  most 
acute  cases ;  but,  on  the  other  hand,  it  is  not  less  potent  even 
in  the  most  chronic  cases,  and  in  them  the  effect  of  one  dose  will 
endure  for  a  period  of  three  weeks,  or  even  more."  On  this 
point  I  believe  that  there  is  no  difference  in  the  opinion  of  ex- 
perienced practitioners  of  Homoeopathy.  Few  medicines  pro- 
duce more  enduring  effects  upon  the  animal  oeconomy  than 
Belladonna. 

1.  Of  its  power  to  dilate  the  pupil  nothing  need  be  said. 
Belladonna  is  the  mydriatic. 

2  &  3.  Paleness  of  the  face,  and  twitches  of  the  muscles  of 
the  eyes  and  face. 

We  have  these  symptoms  accurately  reproduced  in  Hahne- 
mann's proving. 

170.  Distorted  features. 

171.  Paleness  of  the  face. 

174.  Sudden  paleness  of  the  face  lasting  some  time. 

4  &  5.  Loss  of  consciousness,  and  tonic  contraction  of  the 
lar}^ngeal  and  expiratory  muscles. 

In  a  case  reported  by  Dr.  Gray,  of  New  York,  we  are  told 
"  that  the  patient's  manner  was  apoplectic,  respiration  anxious, 
and  attended  with  brazen  stridulous  sound."  He  afterwards 
speaks  of  it  as  a  state  of  "  partial  coma."  The  narcotising 
power  of  Belladonna,  and  especially  of  its  alcaloid  atropine,  is 
too  well  established  to  require  further  illustration.  What 
makes  Belladonna  especially  suitable  for  Epilepsy  is  the  mix- 
ture of    sjonptoms  of  stupor  and  spasms  at  a  stage  of  the 


Lecture  ly  Dr.  Russell  on  Epilepsy,  273 

operation  of  the  drug  prior  to  the  production  of  the  true  coma. 
In  this  patient  of  Dr.  Gray's,  for  example,  the  state  of  coma 
alternated  with  paroxysms  of  uncontrollable  tendency  to  motion 
and  rapid  automatic  movement.  Here  we  have  an  exact  sirrdh 
of  the  first  §tage  of  Epilepsy  before  the  profound  stupor  sets  in. 
6.  Cry. 

Hahnemann  has,  among  the  symptoms  he  collected  from 
Greding,  recorded  the  foUoMdng,  1322  : — "With  a  sudden  cry 
he  trembles  in  the  hands  and  feet" 

The  fall,  the  asphyxia,  and  the  violent  general  convulsions, 
are  by  no  means  peculiar  to  Belladonna.     All  narcotics  which 
have  the  power  of  producing  a  state  of  true  coma,  do  so  by 
causing  in  some  way  or  other  venous,  instead  of  arterial,  blood 
to  circulate  in  the  brain.     After  a  certain  point  the  symptoms 
are  not  those  of  the  drug,  but  those  of  venous  intoxication ; 
and  we  must  be  on  our  guard  not  to  argue  from  the  appearance 
of  post'Coma  convulsions,  among  the  eflfects  of  any  drug,  that 
it  therefore  possesses,  any  true  spasms-causing  power.     The  ex- 
periments of  Sir  Astley  Cooper  abundantly  prove  that  the  inter- 
ruption of   the  flow  of  arterial  blood  to  the  brain  is  quite 
sufficient  to  induce  violent  epileptic-form  paroxysms.     But  the 
condition  of  the  animal  so  treated  is  entirely  different  from 
those  in  a  truly  epileptic  condition — such  as  Dr.  Brown-S^quard 
induces  by  injuries  of  the  central  parts  of  the  nervous  system. 
This  is  not  so  with  Belladonna,  for  the  more  we  investigate 
the  effects  of  this  drug,  the  more  am  I  convinced  we  shall  find 
in  it  the  symptoms  bearing  a  close  resemblance  with  all  the 
essential  ones  of  Epilepsy ;  and  if  we  pass  from  the  observed 
phenomena  to  their  probable  causes,  I  believe  that  the  reason 
why  Belladonna  produces  the  image  of  the  natural  disease  is 
because  it  has  the  power  both  to  induce  in  the  central  parts  of 
the  nervous  system  a  morbid  congestion ;  and,  also,  to  excite  in 
the  peripheral  nerves  a  morbid  supersensitiveness  to  impres- 
mosiB ;  80  that  while  on  the  one  hand  it  predisposes  to  con- 
Yiilsi<»is  by  accumulating  blood  in  the  spinal  cord,  medulla 
VOL.  hl  18 


274  Lecture  hy  Dr.  Russell  on  Epilepsy. 

oblongata,  and  brain ;  on  the  other  hand,  it  facilitates  the 
operation  of  the  exciting  causes  of  those  convulsions  by  render- 
ing the  surfaces  of  the  body  (both  the  external — the  skin,  and 
the  internal — the  mucous  membranes),  more  liable  to  be  offended 
by  every  irritant. 

The  expectations  raised  by  a  study  of  the  symptoms  pro- 
duced by  this  wonderful  drug,  when  given  as  a  poison,  or  to 
ascertain  its  action  in  the  heathy  person,  have  been  fully 
realized  by  the  effects  observed  of  its  administration  in  the 
treatment  of  epilepsy. 

The  curative  ef&cacy  of  Belladonna  in  epilepsy  is  attested 
by  so  many  trustworthy  observers,  that  my  surprise  is  that  it 
has  not  won  a  more  general  acceptance  by  thr  medical  profes- 
sion at  large.  My  own  experience  in  favour  of  Belladonna  is 
that  it  actually  cures  this  disease  even  when  it  presents  itself 
in  its  most  formidable  character.  I  may  give  one  or  two 
cases  in  illustration  of  the  grounds  of  my  confidence  in  this 
medicine. 

A.  G. — Oct.  17. — ^A  well-grown  and  intelligent  lad  became 
subject  to  epilepsy  three  years  ago.  After  the  first  fit  there 
was  an  intermission  for  two  months,  then  he  had  two  fits ; 
after  that  they  recurred  at  intervals  of  every  two,  three,  or 
four  months.  He  consulted  me  on  the  24th  of  August,  1855, 
he  had  six  fits  on  the  previous  day,  and  one  that  morning. 
The  fits  begin  with  convulsions  of  the  muscles  of  the  face, 
which  extend  to  the  arms  and  legs.  He  is  generally  uncon- 
scious for  twenty  minutes.  He  was  ordered  two  drops  of  the 
second  dilution  of  Belladonna  three  times  a  day.  He  took  this 
medicine  tUl  the  1 1th  of  January,  when  he  had  one  fit  during 
the  night.  The  medicine  was  continued  till  the  14th  of  July, 
and  there  was  no  return  of  a  fit.  I  believe  he  has  kept  quite 
free  of  them  ever  since.  He  certainly  was  so  for  some  years. 
The  fits  were  of  the  true  epileptic  character,  and  in  some 
respects  bad  ;  for  there  was  very  deep  coma,  and  the  length  of 
a  paroxysm  was  rather  above  the  average  period.     He  took  the 


Lecture  by  Dr.  RvMell  on  Epilepsy,  275 

medicine  for  eleven  months;  and,  as  the  fits  came  on  about 
the  age  of  puberty,  and  were  increasing  in  severity  and  numbers 
for  three  years,  the  chances  of  this  favourable  termination  being 
spontaneous  are  certainly  not  so  great  as  that  they  were  cured 
by  Belladonna. 

Case  II. — A  fine  intelligent  boy  of  14  years  of  age  came 
under  my  care  upon  the  l7th  of  December,  1855.  His 
parents  stated  that  he  had  been  subject  to  convulsions  as  an 
infant,  and  from  that  time  he  had  suffered  from  strabismus. 
His  present  malady  has  lasted  for  one  year.  He  is  affected 
with  an  unpleasant  sensation  coming  over  head  and  hands 
several  times  a  day,  and  one  or  two  regular  epileptic  fits  every 
day.  His  general  health  is  good.  On  the  31st  of  December 
he  began  to  take  the  second  dilution  of  Belladonna  three  times 
a  day,  and  continued  to  do  so  till  the  end  of  April  During 
the  whole  of  these  four  months  he  remained  perfectly  free  from 
aU  epileptic  symptoms  or  paroxysms ;  and,  so  far  as  I  know, 
he  has  been  in  perfect  health  ever  since.  The  slight  general 
uneasiness  this  boy  complained  of  is  very  characteristic  of  true 
epilepsy,  and  I  have  no  doubt  this  case  was  an  example  of  that 
disease,  and  that  it  was  radically  cured  by  Belladonna. 

Case  III.^A  big  lad,  19  years  of  age,  of  a  very  dull 
expression  of  countenance,  and  an  almost  idiotic  gait  and  de- 
meanour, was  brought  to  me  on  the  16th  of  March,  1856.  He 
had  been  suffering  from  epilepsy  for  six  years.  The  fits  oc- 
curred two  or  three  times  a  day,  but  not  every  day.  He  was 
ordered  to  take  a  dose  of  the  second  dilution  of  Belladoima 
three  times  a  day.  He  returned  on  the  2nd  of  April,  and  his 
mother  reported  that  he  had  had  two  bad  fits  the  last  week. 
The  medicine  was  continued.  He  remained  free  of  all  attacks 
till  the  14th  of  May,  on  which  day  he  had  one  fit.  On  the 
23  rd  of  July  he  was  brought  to  me  again.  His  mother  as- 
sured me  that  there  was  a  marked  improvement  in  his  general 
intelligence,  and  that  the  fits  were  less  frequent  and  less  severe. 
After  this  I  lost  sight  of  the  case. 

18* 


276  Lecture  hy  Dr.  Russell  on  Epilepsy, 

Case  IV. — A  girl  of  14  years  of  age,  of  healthy  appearance, 
was  brought  for  my  advice  on  the  20th  of  March,  1857.  ronr 
years  ago,  i.  e.,  when  she  was  ten  years  old,  she  had  her  first 
epileptic  fit.  It  occurred  without  any  assignable  cause,  and 
was  very  severe.  The  fits  returned  at  irregular  intervals  until 
a  year  ago,  when  they  began  to  occur  regularly  every  month. 
They  last  for  about  fifteen  minutes,  and  end  in  sleep.  When 
she  applied  to  me  she  had  been  free  for  three  weeks,  and 
reckoned  on  one  being  due  on  the  following  week.  The  second 
dilution  of  Belladonna  was  prescribed,  a  dose  to  be  taken  three 
times  a  day.  There  was  no  fit  from  the  20th  of  March  till  the 
22  nd  of  June,  and  none  between  that  and  the  12th  of  No- 
vember. Thus,  instead  of  eight  fits  in  eight  months,  she  had 
only  two  fits,  and  I  believe  she  kept  well  from  that  time.  As 
I  find  no  mention  made  in  my  notes  of  the  appearance  of  the 
catamenia,  I  presume  that  this  change  in  the  constitution  had 
not  occurred  during  the  treatment,  and  that  the  amendment 
was  due  to  the  persistent  use  of  Belladonna. 

These  four  cases  occurred  when  I  was  practising  in  Leaming- 
ton, and  along  with  some  other  striking  recoveries  or  improve- 
ments in  similar  cases,  were  so  much  talked  of  that  I  was  con- 
sulted by  a  great  many  epileptic  patients,  and  have  ever  since 
had  a  number  of  such  cases  under  my  care.  I  must  make 
the  mortifying  confession  that  although  even  in  apparently 
very  bad  cases  I  have  been  able  to  effect  great  improvement, 
yet  that  in  very  many  I  have  foimd  myself  entirely  baffled; 
and  the  tantalising  feature  of  the  affair  is,  that  I  find  I  cannot 
pronounce  with  any  confidence  as  to  the  probability  of  the  issue 
in  any  given  case.  I  know  of  no  special  indications  for  the 
use  of  Belladonna,  nor  do  I  know  beforehand  whether  a  case 
will  get  better  or  worse,  or  remain  stationary.  I  have  been 
disappointed  in  cases  which  looked  the  most  promising,  and  again 
other  cases  which  presented  all  the  worst  appearances  have 
been  the  most  benefitted. 

The  next  medicine  to  which  I  wish  to  direct  your  attention, 
is  Hydrocyanic  acid. 


Lecture  hy  Dr,  Russell  on  Epilepsy.  277 

Tn  the  number  of  the  British  Journal  of  Homeopathy  for 
July,  1862,  there  is  an  elaborate  article  by  Dr.  Madden  and 
Dr.  Hughes  upon  the  action  of  Hydrocyanic  acid,  and  especially 
upon  its  relation  to  epilepsy.  At  the  end  of  the  article  there  is 
the  following  note  : — "  In  the  next  number  of  the  journal  we 
propose  to  give  a  series  of  cases  of  epilepsy  and  other  diseases 
treated  by  this  drug.  If  any  of  our  colleagues  have  had  ex- 
•  perience  with  it,  or  should  be  led  to  use  it  successfully  in  the 
direction  indicated  in  the  above  paper,  we  should  be  greatly 
obliged  if  they  would  communicate  to  us  their  observations, 
that  we  may  incorporate  them  in  our  series."  Having  been  for 
long  much  interested  in  the  subject  of  epilepsy,  I  have  opened 
each  of  the  successive  numbers  of  the  journal  with  great  curi- 
osity to  read  the  cases  which  are  here  referred  to  as  having 
been  treated  before  July,  1862,  with  this  drug.  Up  to  this 
time,  however,  they  remain  unpublished,  and  in  the  absence  of 
all  a  posteriori  evidence  in  favour  of  the  power  of  Hydrocyanic 
Acid  to  cure  epilepsy,  we  must  examine  even  more  critically  the 
preofe  advanced  in  the  paper  just  referred  to. 

Having  already  confessed  how  often  I  have  been  baffled  in 
all  my  attempts  to  effect  a  cure  of  epilepsy,  I  need  hardly  say 
that  I  began  the  perusal  of  the  article  with  a  lively  hope  of 
finding  the  authors  of  it  to  be  right  in  their  belief  that  Hydro- 
cyanic Acid  deserved  a  place  next  to  Belladonna  in  the  treat- 
ment of  this  dreadful  malady.  This  hope  seemed  to  me  the 
more  legitimate  inasmuch  as  we  had  from  the  same  joint-pen 
received  so  valuable  an  article  upon  the  relation  of  Belladonna 
to  this  disease — an  article  which  showed  that  its  authors  had 
carefully  arranged  in  their  preper  order,  and  valued  at  their 
just  proportion,  the  symptoms  which  characterise  epilepsy. 
However,  I  must  at  once  confess  that  the  more  I  studied  the 
article  the  less  I  was  satisfied  with  the  conclusions  arrived  at 
in  it,  I  wiU  state  my  opinions  rather  in  the  form  of  questions 
than  of  opposing  prepositions. 
.  The  first  I  would  note  is  whether  there  is  any  evidence  of 


278  Lecture  by  Dr,  Russell  on  Epilepsy, 

Hydrocyanic  Acid  producing  a  permanent  impression  upon  the 
nervous  system  ?  To  me  it  seems  to  act  as  a  very  intense  and 
very  evanescent  direct  sedative.  Let  us  take,  for  example,  a 
case  recorded  in  the  "Eevue  Medicale,"  and  quoted  by  Chris- 
tison  and  Hempel,  as  well  as  by  the  authors  of  the  article  under 
consideration.  It  is  quite  a  model  case,  and  the  substance  of 
it  is  thus  given  by  Drs.  Hughes  and  Madden : — 

"  Very  soon  after  swallowing  a  teaspoonful  of  the  diluted  • 
acid,  he  felt  a  confusion  in  his  head,  and  then  fell  down  in- 
sensible as  suddenly  as  if  struck  by  lightning."  Let  us  pause 
to  observe  that  up  to  this  point  there  had  been  no  convulsions, 
nor  any  symptoms  beaiing  any  resemblance  to  epilepsy.  And 
this  is  the  rule,  not  the  exception.  Thus  a  case  is  related  in 
"  Hufeland's  Journal,"  and  quoted  by  Wibmer  and  Christison, 
of  a  man  who  took  a  large  dose  of  this  poison,  and  "  after  stag- 
gering a  few  steps  he  sank  without  a  groan  (and  without  a 
struggle)  to  the  ground.  A  physician  who  saw  him  on  the 
instant  found  the  pulse  gone  and  the  breathing  for  some  time 
imperceptible."  To  return  to  the  former  case,  the  narrative 
proceeds : — "  There  was  difficult  breathing ;  small  pulse,  scarcely 
perceptible  at  the  left  wrist ;  bloating  of  the  face  and  neck ; 
dilated  and  insensible  pupils;  and  lock-jaw.  Afterwards  he 
had  several  fits  of  tetanus,  one  of  them  extremely  violent.  In 
about  two  hours  and  a-half  he  began  to  recover  his  intellect, 
and  rapidly  became  sensible."  On  this  we  have  the  following 
comment : — "  The  epileptiform  loss  of  consciousness,  the  tetanic 
convulsions,  and  the  spasmodic  dyspnoea  of  Hydrocyanic  Acid, 
are  well  marked  in  this  case."  I  confess  I  cannot  see  the  re- 
semblance to  epilepsy.  It  seems  to  me  much  more  like  a 
transient  attack  of  apoplexy ;  for  let  us  observe  that  the  con- 
vulsions did  not  occur  at  all  till  after  the  bloating  of  the  face 
and  the  insensibility  of  the  pupils  demonstrated  that  narcosis, 
or  poisoning  of  the  brain  by  venous  blood,  had  taken  place.  It 
was  a  toxical  repetition  of  Sir  A.  Cooper's  experiments.  The 
supply  of  arterial  blood  was  suddenly  cut  off  from  the  brain 


Lecture  hy  Dr,  Russell  on  Epilqpsy.  279 

medulla  oblongata,  and  spinal  chord,  and  the  consequences  of 
this  were  insensibility  and  convulsions.  And  so  little  had  the 
poison  affected  the  nervous  centres  in  a  strictly  morbific 
manner,  that  very  soon  he  began  to  recover,  and  so  far  as  we 
know  was  no  more  affected  by  this  powerful  drug  than  if  he 
had  been  strangled  and  restored  to  life.  In  fact  the  symptoms 
are  those  of  strangulation,  and  as  such  they  bear  a  close  resem- 
blance to  the  effects  of  an  epileptic  seizure,  which  indeed 
strangles  its  victim  as  effectually  as  if  a  bow  string  were 
tightened  round  his  throat.  But  again  I  say  I  see  no  proof 
of  Hydrocyanic  Acid  acting  directly  on  that  part  of  the  nervous 
system  which  is  the  seat  of  epilepsy.  We  miss  entirely  the 
early  dilatation  of  the  pupil  before  the  establishment  of  uncon- 
sciousness, which  is  one  of  the  pathognomonic  symptoms  of  the 
malady. 

Is  there  any  evidence  of  Hydrocyanic  acid  exerting  a  long- 
continued  morbific  influence  ?  Are  not  its  effects  like  those 
of  camphor — ^very  powerful,  but  very  evanescent  ? 

Have  we  sufficient  evidence  of  its  action  when  given  much 
diluted  ?  I  mean,  as  we  are  in  the  habit  of  prescribing  our 
medicines.  Will  the  millionth  of  a  drop  produce  any  effect  ? 
We  know  that  a  pure  stimulant  is  annihilated  by  dilution,  as 
in  the  instance  of  Alcohol.  May  it  not  be  the  same  with  a  pure 
sedative  ?  These  are  very  important  questions  to  have  answered 
before  we  place  our  confidence  in  this  remedy,  and  questions 
which  I  trust  we  shall  have  answered,  as  well  as  the  produc- 
tion of  the  promised  cases  exhibiting  the  curative  efficacy  of 
Hydrocyanic  Acid  in  epilepsy. 

Ouprum,  either  in  the  form  of  the  triturated  metal,  or  of  the 
acetate  of  copper,  is  in  high  favour  in  the  Homoeopathic  treat- 
ment of  epilepsy;  and  certaruly  it  seems  to  fulfil  the  conditions 
we  require  of  an  anti-epileptic  medicine ;  for  its  effects  are  both 
peripheral  and  central,  and  of  long  endurance.  For  example, 
Wibmer  relates  the  case  of  a  girl  of  eighteen  years  of  age  who 
was  poisoned  with  a  salt  of  copper,  and  in  whom  it  produced 


280  Lecture  by  Dr.  RiisseU  an  Epilepsy. 

convulsions,  and  then  insensibility.  Some  days  afterwards  a 
certain  amount  of  paralytic  weakness  of  the  arms  remained^ 
general  disturbance  of  the  whole  system  followed,  and  even- 
tually she  died.  After  detailing  a  number  of  cases  of  poisoning 
by  the  acetate  of  copper  Wibmer  concludes  with  the  following 
summary  : — 

"Various  observations  make  it  probable  that  copper  acts 
upon  the  brain,  and  even  more  upon  the  spinal  chord.  We 
meet  with  headache,  often  irrational  talk,  slight  deafness,  but 
more  frequently  twitches,  trismus,  and  almost  tetanic  stiffness 
of  the  limbs,  as  consequences  of  poisoning  by  this  metaL" 

In  the  proving  of  Cuprum  given  to  us  by  Hahnemann 
we  find  numerous  symptoms  and  groups  of  symptoms  bearing 
a  close  resemblance  to  those  of  a  paroxysm  of  epilepsy.  Ifoack 
and  Trinks  observe  that  Cuprum  "  is  especially  suitable  for 
relaxed,  irritable,  and  nervous  constitutions,  with  weakness  and 
excessive  sensitiveness  of  the  nervous  system." 

So  far  as  my  own  observations  go,  I  must  admit  that  I  have 
been  disappointed  in  this  remedy  in  the  treatment  of  epUepsy, 
and  I  am  inclined  to  think  that  the  action  of  copper  ia  rather 
upon  the  ramifications  of  the  nerves  than  upon  their  central 
origin.  It  is  of  great  use  in  certain  forms  of  spasms  arising 
from  which  might  be  caUed  circumscribed  reflex-action,  as  in 
some  kinds  of  colic,  and  choleraic  spasms.  It  is  likewise  of 
great  use  in  certain  forms  of  oppression  of  the  brain ;  but  it 
does  not  seem  to  act  so  specifically  on  the  upper  part  of  the 
spinal  chord  or  medulla  oblongata ;  it  does  not,  like  Belladonna^ 
dilate  the  pupils.  In  short,  although  presenting  many  striking 
features  of  resemblance  in  its  effects  to  the  symptoms  of 
epilepsy,  it  does  not  seem  to  hit  the  exact  likeness,  and  is  per- 
haps more  suitable  for  various  kinds  of  epileptiform  convulsions, 
and  for  general  choraic  tremors  than  for  true  epilepsy. 

I  have  certainly  seen  decided  benefit  from  Arsemcum — a 
medicine  not  nearly  so  much  in  vogue  among  Homoeopathists 
for  the  cure  of  epilepsy.   That  Arsenicum  does,  however,  some- 


Lectv/re  hy  Dr.  Russell  on  Epilepsy,  281 

times  produce  a  set  of  symptoms  closely  resembling  those  of 
epilepsy  is  undoubted,  and  well  illustrated  in  the  following 
case: — 

"  A  girl  swallowed  a  drachm  of  arsenic,  and  was  in  conse- 
quence attacked  violently  with  the  usual  symptoms  of  irritation 
in  the  whole  alimentary  canaL  After  a  succession  of  ordinary 
symptoms,  a  new  train  gradually  appeared.  Towards  the  close 
of  the  second  day  she  was  harrassed  with  frightful  dreams, 
starting  from  sleep,  and  a  tendency  to  faint ;  with  coldness 
along  the  spine,  giddiness,  and  intolerance  of  light ;  and,  on  the 
fourth  day,  with  aching  of  the  extremities  and  tingling  of  the 
whole  skin.  This  symptom  continued  till  the  close  of  the 
sixth  day,  when  she  was  suddenly  seized  with  convulsions  of 
the  left  side,  foaming  at  the  mouth,  and  total  insensibility. 
The  convulsions  lasted  two  hours,  the  insensibility  through  the 
whole  night  iText  evening  she  had  another  and  similar  fit ; 
a  third,  but  slighter,  occurred  on  the  morning  of  the  tenth; 
another  next  day  at  noon ;  and  they  continued  to  occur  occa- 
sionally till  the  nineteenth  day.*' 

The  gradual  formation  of  the  epileptic  condition  is  curiously 
exhibited  here.  Over  sensitiveness  of  the  periphereal  nerves, 
so  that  there  was  more  than  the  proper  amount  of  stimulus 
borne  inwards  to  the  centre,  while,  at  the  same  time,  an  ab- 
normal state  of  the  upper  part  of  the  spinal  chord  was  engen- 
dered, in  consequence  of  which  there  was  preternatural  tendency 
on  its  part  to  be  excited.  Here  we  had  the  train  laid  by  one 
hand,  and  the  match  applied  by  the  other. 

It  is  further  to  be  observed,  in  regard  to  Arsenicum,  that  it 
produces  intermittent  fever ;  and  Dr.  Brown-S^quard  has  pointed 
out  that  the  ague,  and  epileptic  conditions  of  the  body  are  reci- 
procally antagonistic.  For  these  reasons,  as  well  as  on  the 
grounds  of  having  seen  it  do  good,  I  am  disposed  to  press  this 
medicine  on  your  attention  in  cases  of  epilepsy. 

Another  medicine,  which  has  seemed  to  me  of  unequivocal 
benefit,  is  Jjfajay  and  we  should  expect  it  to  be  so  from  the 


282  Lecture  by  Dr.  Russell  on  Epilepsy, 

effects  it  produces  when  it  enters  the  system  in  such  a  way  as 
to  exert,  to  its  full  extent,  its  morbific  influence.  In  the 
reports  of  fatal  cases  from  the  bite  of  the  cobra  di  capello  we 
have  the  most  characteristic  symptoms  of  epilepsy  occurring  in 
the  proper  order  of  succession.  First,  there  are  convulsive 
twitches  of  various  muscles,  showing  a  general  agitation  of  the 
peripheral  nerves ;  then  come  insensibility  and  violent  convul- 
sions, with  foaming  at  the  mouth.  Dilatation  of  the  pupil  is 
also  sometimes  observed  at  an  early  stage.  Thus  from  Lachesis 
and  Naja  we  have  every  reason  to  expect  good  results  in  the 
treatment  of  epilepsy;  and,  so  far  as  my  experience  goes,  it 
confirms  these  expectations. 

From  Nitrate  of  Silver  I  have  never  succeeded  in  obtaining 
any  satisfactory  results.  This  may  be  owing  to  its  popular  use 
and  even  abuse ;  for,  as  it  rarely  happens  to  us  to  be  called 
on  to  treat  a  case  of  epilepsy  which  has  not  been  previously 
under  any  course  of  medical  treatment,  in  the  majority  of  our 
cases  this  remedy  has  been  given,  and  failed  to  do  good.  Dr. 
Gray,  of  !N'ew  York,  than  whom  we  have  no  more  trustworthy 
observer,  tells  us  that  "Epileptic  attacks  produced  by  moral 
causes,  e.g.,  impassioned  lay  preaching,  are  promptly  and  directly 
cured  by  a  few  small  doses  of  this  medicine." 

Nux  Vomica  is  certainly  a  most  useful  medicine  in  the  treat- 
ment of  epilepsy ;  but  rather,  as  it  appears  to  me,  by  removing 
the  peripheral  exciting  causes,  than  by  acting  on  the  abnormal 
condition  of  the  nervous  centres.  However,  as  I  have  seen 
undoubted  benefit  from  its  action  in  some  obstinate  and  severe 
cases,  we  should  not  deprive  ourselves  of  its  use  by  any  specu- 
lative objections  as  to  its  inability  to  produce  the  cerebral  op- 
pression which  characterizes  epilepsy. 

The  same  observations  hold  good  of  Pulsatilla. 

In  thus  winnowing  out  of  Dr.  Laurie's  fifty  medicines  these 

five  or  six,  I  by  no  means  wish  to  cast  a  slight  upon  the  others; 

but,    as  these  are    clenical  lectures,  I  have  confined  myself 

exclusively,  or  nearly  so,  to  giving  expression  to  the  result  of 


Cases  by  Mr.  Yeldham.  283 

my  own  personal  experience  and  observation.  I  only  regret 
that  it  is  not  more  satisfactory ;  and  I  trust  that,  by  and  bye, 
we  shall  have,  instead  of  vaguQ  indications  and  general  direc- 
tions for  the  use  of  remedies  in  epilepsy,  a  collection  of  well- 
attested  cures  of  this  terrible  affliction,  so  that  we  may  discover, 
with  some  approach  to  accuracy,  what  are  the  peculiar  indica- 
tions on  which  we  may  rely  for  giving  a  preference  to  one 
remedy  rather  than  to  another,  in  selecting  that  which  is  the 
most  appropriate  to  every  particular  case  of  the  disease,  to- 
wards the  cure  or  mitigation  of  which  our  remedial  efforts  are 
directed. 


CASES  TEEATED  WITH  HIGH    DILUTIONS,    BY  MR. 
YELDHAM,  M.RC.S.,  Surgeon  to  the  Hospital. 

Case  VTI. — ^Frederick  Goodman,  aged  16  :  admitted  No- 
vember  12,  1863  :  discharged  December  2nd.     Result,  cured. 

Oastric  irritation  with  headache. — A  fortnight  ago  was  seized 
with  pain  in  the  head  and  loins,  with  tendency  to  fever.  The 
pain  in  the  head  has  continued  ever  since. 

Nov.  13th. — He  now  complains  of  dull  heavy  pain  in  the  front 
of  the  head — ^heis  evidently  much  oppressed  by  it — ^it  causes  him 
to  stoop,  and  to  move  with  great  caution,  and  to  avoid  the  light. 
He  has  neither  appetite  nor  thirst ;  tongue  dry,  and  red  in  the 
centre :  white  and  moist  over  the  rest  of  its  surface,  except  the 
edges  which  are  clean.  Pulse  84 ;  skin  hot  and  moist;  bowels 
inclined  to  be  relaxed ;  urine  high  coloured. 

Aconite  tinct.  200,  a  drop  three  times  a  day. 

Nov.  19  th. — StUl  pain  in  the  forehead,  at  times ;  feels  weak  ; 
tongue  slightly  coated. 

Nux  Vomica  200,  three  times  a  day. 

Nov.  23rd. — Head  better,  though  there  is  still  dull  pain  in 
the  forehead.  Has  pain  in  the  abdomen,  after  food,  as  if 
from  flatulence. 

Saccharum  Lactis. 


284  C(wes  hy  Mr.  Yeldham. 

Nov.  25th. — Head  worse  yesterday  and  to-day:  astupifying, 
dull,  heavy  pain ;  stomach  uncomfortable  after  food. 

Nux  Vomica,  first  decimal,  a  drop  three  times  a  day. 
Nov.  30th. — Very  much  better;  very  slight  pain  in  the  fore- 
head ;  has  slight  pain  across  the  epigastrium. 

Continue  the  Nux  Vom.,  first  decimal 
Dec.  2nd. — -Feels  quite  well.     Discharged,  cured. 

Case  VIII. — ^Ellen  Mills,  aged  37;  single;  servant — admit- 
ted November  27th ;  discharged,  December  21st.    Eesult,  cured. 

Gastrosis. — ^Three  weeks  ago  felt  a  pain  in  the  bowels  after 
dinner,  which  has  continued  up  to  this  time.  Now  complains 
of  constant  violent  pain,  principally  in  the  epigastric  region, 
shooting  through  to  the  back ;  worse  after  food,  and  increased 
by  pressure.  When  first  seized  had  sickness  and  vomiting  after 
every  meal,  but  these  symptoms  have  abated  within  the  last 
week.  There  is  no  appetite ;  thirst,  and  bad  taste  in  the  mouth ; 
bowels  act  regularly;  has  headache;  skin  cool. 

Take  Aconite  200,  a  drop  three  times  a  day. 

Nov.  30th. — Much  the  same. 

Take  Belladonna  200,  a  drop  every  four  hours. 

Dec.  4th. — Continues  the  same. 

Take  Belladonna,  first  decimal,  3  drops  every  four  hours. 

Dec.  7th. — Considerably  better ;  pain  stUl  felt,  though  in  a 
very  mitigated  degree. 

Continue  same  medicine. 

Dec.  9th. — More  pain  across  the  colon  since  yesterday 
afternoon,  with  some  frontal  headache. 

Saccharum  Lactis. 

Dec.  12th. — Very  considerably  better;  pain  greatly  dimi- 
nished, both  after  food  and  at  other  times. 

Dec.  14th. — Still  better,  even  when  sitting  up,  which 
hitherto  has  much  increased  the  pain — felt  only  when  lying 
on  the  left  side. 

Saccharum  Lactis. 


Cases  hy  Mr,  Yeldham,  285 

Dec.  16th. — ^Much  same  as  at  last  visit,  still  some  discomfort 
after  food. 

Cocculus  200,  a  drop  three  times  a  day. 

Dec.  19th. — Better;  sat  up  yesterday  with  greater  ease  than 
before. 

Dec.  21st. — Pain  scarcely  felt  at  all;  feels  sufficiently  well 
to  go  home.     Discharged. 

Case  IX. — James  Rayman,  aged  30  ;  a  labourer — admitted 
November  12,  1863;  discharged,  December  14.    Result,  cured. 

Ague, — A  stout,  muscular  man.  About  three  weeks  since 
got  wet  and  caught  cold ;  he  coughed  for  a  week  and  then  had 
a  shivering  fit ;  this  recurred  every  second  night  until  four  days 
ago,  since  when  he  has  had  the  shivering  every  night.  In  Oc- 
tober, was  working  three  weeks  in  the  Wolds  of  Yorkshire, 
where  ague  prevails.  On  admission,  states  that  for  the  last 
four  days  the  shivering  has  come  on  about  three  or  four  o'clock 
each  morning,  has  lasted  for  an  hour,  and  has  been  followed  by 
hot  stage,  which  lasts  about  half  an  hour,  and  is  succeeded  by  a 
gentle  perspiration.  He  is  always  thirsty,  but  more  so  during 
the  hot  stage.  Pulse,  at  eleven  a.m.,  90.  Skin  cool;  tongue 
coated  white ;  urine  high  coloured,  and  thick ;  bowels  regular ; 
has  slight  cough  at  night. 

Take  Arsenicum  200,  a  drop  every  four  houra. 

Nov.  1 9  th. — Shiveringshave  recurred  much  the  same  as  usual, 
perhaps  a  little  slighter  last  night ;  less  heat  and  sweating ;  ex- 
ceedingly thirsty  in  the  night ;  pulse  112,  weak,  ansemic  looking 
and  feels  exceedingly  prostrated ;  tongue  broad,  red,  and  glazed. 
Arsenicum  3rd  decimal,  a  drop  every  four  hours. 

Nov.  21st. — Had  shivering  on  the  20th.  Last  night  had 
copious  sweating  between  twelve  and  one  o'clock,  but  no 
shivering;  slight  thirst. 

Nov.  23rd. — ^At  noon,  on  21st,  had  a  shivering  fit  which  lasted 
an  hour  and  a  half.  Fever  followed,  but  no  sweat.  Has  had  no 
shivering  since,  but  feels  giddy,  and  has  a  mist  before  his  eyes, 
at  times. 

Continue  same  medicine. 


286  Cases  hy  Mr.  Yeldham. 

Nov.  25th. — For  last  two  nights  the  shivering  has  been  as 
before,  has  come  on  at  the  usual  time,  and  has  been  succeeded 
by  fever  and  sweating. 

Chinium  Sulphuricum,  ^  5  drops  every  four  liours. 
Nov.  30th. — Continues  much  the  same. 

Chinium  Sulphuricum  ^  grain  every  two  hours. 
Dec.  2nd. — Shiverings  the  last  two  days  have  come  on  at  six 
in  the  morning. 

Chinium  Sulphuricum  ^  grain  every  two  hours. 
Dec.   4th. — Yesterday   shivering  came  on  at  noon.     Feels 
better  to-day. 

Continue  same  medicine. 
Dec.  7th. — No  shivering  the  last  two  days. 
Dec.  9  th. — Has  had  no  shivering.     Improves  rapidly. 

Eepeat  the  same  medicine  every  four  hours. 
Dec.  12  th. — No  shivering.     Well,  except  a  little  uneasiness 
in  the  loins. 

Dec.  14th. — No  recurrence  of  the  shiverings.  Feels  quite 
well,  and  is  discharged. 

CsEA  10. — Jane  Amos,  aged  21;  married;  admitted  Oct* 
20th,  1863  ;  discharged  Nov.  18th.  Result,  relieved.  Disease, 
Rheumatism. 

When  six  years  old,  and  again  when  ten,  had  Rheumatic 
fever.  Since  last  attack  has  enjoyed  good  health  till  a  fomight 
ago,  when  she  felt  pains  in  head,  shoulders,  and  arms.  These 
pains  have  continued,  more  or  less,  since.  On  admission  com- 
plains of  pain  on  motion  in  back  of  neck  and  shoulders.  Her 
tongue  is  clean  at  edges  and  in  centre,  but  has  two  stripes  of 
fur ;  appetite  fair ;  bowels  regular ;  catamenia  ditto ;  Pulse  110  ; 
skin  cool ;  sleeps  badly ;  heart  sounds,  normal 

Oct.  23.  Aconite  200,  three  times  a  day. 

Oct.  25th.  Worse.     Pain  has  extended  to^the  other  shoulder. 
Bryonia  200,  a  drop  every  four  honrs. 

Oct.  28  th.  Better  in  herself.  Left  shoulder  painful,  like  knives 


Cases  by  Mr.  Yeldham,  287 

pricking  her,  and  preventing  sleep.     Not  so  thirsty.     Tongue 
deeming. 

Continue  Bryonia,  200. 

Oct.  30th.  Less  pain  in  shoulder,  can  move  it  better. 

Nov.  2nd.  Flying  pains  in  different  parts  of  body,  though 
generally  better. 

Pulsatilla  200,  a  drop  every  four  hours. 

Nov.  5th.  Feverish  all  night  and  no  sleep.  Catching  pain  in 
right  side  of  chest  on  moving  and  breathing,  and  in  the  region 
of  the  heart,  the  sounds  of  which  are  healthy.  Pulse  120.  She 
has  had  meat  diet  hitherto,  and  is  now  to  omit  it. 

Take  Aconite  2j00,  a  drop  every  four  hours. 
Nov.  6th.  The  catching  pain  in  right  side  continues. 

Bryonia  200,  every  four  hoois. 
Nov.  9th.  Had  a  good  deal  of  pain  last  night.     This  morning 
it  is  felt  ia  one  foot.     Feverish. 

Aconite  200,  every  four  hours. 

Nov.  11th.  Has  pain  in  the  right  arm,  and  in  the  face  and 
teeth ;  aching,  shooting  pains  which  are  worse  when  the  teeth 
are  closed. 

Merc.  cor.  200,  every  four  hours. 

Nov.  16th.  Varioloid  looking  spots  appeared  on  the  body  two 
days  ago,  these  are  now  dying  off.  She  does  not  progress 
with  respect  to  the  rheumatism.  Has  pains  in  different  parts 
— the  right  wrist  is  swollen  and  painful,  fixedly  so  for  three 
days;  tongue  coated  white,  pulse  quick — 120 — and  weak. 
Bryonia  3rd  dec. ;  three  drops  every  four  hours. 

Nov.  18th.  General  health  better — still  has  flying  pains.  She 
wishes  to  leave  the  hospital,  and  is  to  have  Bryonia  Pilules  of 
the  3rd  to  take  three  times  a  day.     Further  result  not  known. 

Case  11.  James  Hubert;  age  31 — a  shopkeeper.    Admitted 

Dec.  3,  1863.     Discharged  Dec.  23. — Eesult,  cured.    Disease. 

Bronchitis. — Has  been  subject  to  attacks  of  breathlessness 


288  Cases  by  Mr.  Yeldham. 

for  ten  years,  which  seem  to  be  brought  on  by  cold.  Has  had 
such  an  attack  the  last  two  months.  He  is  breathless,  espe- 
cially at  night,  with  a  hard  cough,  and  tough  greenish  expec- 
toration. Has  slight  pain  when  he  draws  a  long  breath. 
Sibilant  rales  are  heard  all  over  the  chest.  Pulse  96,  small; 
skin  cooL  Bowels  regular;  tongue  coated.  Feels  sick  and 
thirsty. 

Tine.  Nux  Vomica  200,  three  times  a  day. 
Dec.  9  th.  Is   easier  ;  cough  looser.     Has  had  a  good  night. 

Continue  medicine. 
Dec.  12th.  Breathing  was  worse  last  night.    Cough  dry,  and 
expectoration  less  easily  raised. 

Tine.  Ipecacuanha  200 ;  three  times  a  day. 
Dec.  16th.  No  better. 

Take  Tine.  Ipecacuanha,   1st  dec.  3  drops  every  four  hours. 
Dec.  19th.   "Feels  decidedly  better  since  beginning  the  last 
medicine."    Less  wheezing,  cough  easier. 

Continue. 
Dec.  21st.  Much  better ;  but  still  coughs  of  a  morning. 

Nux  Vomica  200,  for  three  days. 
Dec.  23rd.  A  little  cough  stiU. 

Discharged. 


g^nnals  of  i^t  S^amt^a. 


OBSEEVATIONS  ON  THE  PHYSIOLOGICAL   AND 
THEEAPEUTIC  EFFECTS    OF  ALCOHOL. 

By  Alfred  C.  Pope, 

Mb.  President  and  Gentlemen, — ^The  daily  consumption 
throughout  the  world  of  alcoholic  fluids,  the  deep  interest  these 
beverages  possess  for  us,  as  the  origin  of  some  forms  of  disease, 
and  the  source  of  the  intractable  nature  of  many  others,  and 
their  admitted  value  as  remedial  agents,  constitute,  for  the  care- 
ful and  impartial  investigation  of  their  physiological  and  thera- 
peutic effects,  claims,  the  strength  of  which  no  one,  I  presume, 
wiU  feel  disposed  to  question ;  the  subject  is  one  to  which,  as 
guardians  of  the  public  health,  we  are  bound  to  accord  a  patient 
and  attentive  consideration.  In  introducing  it  to  you  to-night, 
I  purpose  laying  before  you  a  study  of  the  modus  operandi  of 
alcohol  in  health,  and  therefrom  shall  endeavour  to  deduce  its 
sphere  of  action  in  the  treatment  of  disease. 

In  attempting  to  fulfil  this  intention,  I  propose  to  consider. 
First,  the  symptoms  following  the  use  of  alcohol  in  a  healthy 
man  while  fasting  and  unemployed,  the  results  of  experiments 
upon  the  lower  animals  instituted  with  the  view  of  determining 
its  characteristic  effects,  and  the  modes  of  death,  with  the 
morbid  appearances  ensuing  its  use  in  poisonous  quantities. 
Secondly,  I  shall  examine,  by  the  light  these  facts  afford,  the. 
principal  theories  propounded  to  explain  its  action.  And, 
Thirdly,  from  the  same  source  I  shall  infer  the  nature  of  those 
morbid  conditions,  in  the  treatment  of  which  we  shall  find 
alcohol  to  prove  the  most  serviceable  medicine  we  can  employ. 

By  no  method  can  we  obtain  so  clear  an  insight  to  the 

VOL.  HL  19 


2yo  Obscrvatiuits  un  the  Physloloyical  and 

actions  and  uses  of  any  substance  as  by  that  which,  if  not  first 
])ioj)»)s«m1  by  irabneinann,  was  by  him  unquestionably  first  put 
to  any  ])ractical  use,  and  subsequently  so  developed  as  to  pro- 
vide us  ^vith  a  Materia  Medica,  not  only  extensive,  but  easily 
understood  and  readily  available.  Chemistry,  botany,  or  the 
empirical  use  of  a  presumed  remedy  in  a  variety  of  diseases  can 
never  provide  us  with  information  so  reliable  as  that  derivable 
from  experiments  with  it  on  the  healthy  body.  Amongst  those 
of  our  l^rofession  who  do  not  as  yet  recognize  the  value  of  the 
llomu'opatliic  law  as  a  therapeutic  indicator,  this  method  of  re- 
search n^garding  the  properties  of  new  remedies,  and  of  some 
old  ones,  is  becoming  more  frequent.  We  may  well  congratu- 
late ourselves  that  it  is  so,  seeing  that  if  persevered  in,  it  must 
l(»ad  them — as  seventy  years  ago  it  led  Hahnemann — to  see  in 
the  law  of  similia  similihiis  curantur  the  true  guide  to  the 
select  ion  of  remedies. 

After  this  manner  alcohol  has  been  studied  by  Dr.  Edward 
Smith,  of  the  Brompton  Hospital,  and  to  a  very  slight  extent 
by  Dr.  ('hauibers,  of  St.  Mary's.  The  latter  gentleman  has  yet 
much  to  learn  in  the  matter  of  drug  proving ;  for  when  detailing 
some  of  the  results  of  taking  daily  an  addition  of  a  moderate 
quantity  of  alcohol  to  the  usual  meals,  he  says, — "  On  the  next 
day,  the  a])petite  for  food  was  observed  to  be  somewhat  less 
than  usual,  and  tlie  experiment  ceased ;  for  any  alteration  of 
usual  weight,  health,  feeling,  or  habits,  of  course  would  vitiate 
the  r(\sult  of  an  investigation  conducted  in  this  form."  On  the 
contrary,  it  is  a  knowledge  of  the  changes  in  health,  weight, 
and  feeling  arising  from  the  ingestion  of  a  given  substance,  that 
w^e  desiderate ;  to  obtain  it,  such  experiments  are  alone  under- 
takcjn. 

I)r.  Smith,  however,  w^as  less  chary  of  his  health  and  feelings, 
and  lias,  with  the  assistance  of  a  friend,  furnished  the  Profession 
with  a  very  valuable  proving  of  alcohol.  The  symptons  re- 
sulting iVom  taking  a  moderate  quantity  of  duly  diluted  alco- 
hol, of  brandy,   of  gin,  rum,  whiskey,   ale,   and  porter  on  an 


Therapeutic  Effects  of  A  Icohol  291 

empty  stomach,  early  in  the  morning,  aiv  ji"  on  by  him  in  the 
natnral  order  of  their  succession,  the  duration  of  their  action, 
and  with  their  attendant  circumstances.  They  are  recorded  in 
the  first  volume  of  the  Lancet  for  1861. 

From  this  proving  we  learn  that  the  circulation  was  the 
function  first  impressed;  and,  almost  immediately,  the  brain 
became  excited ;  shortly  afterwards,  the  spinal  cord,  the  respira- 
tion, and,  lastly,  the  sympathetic  system,  gave  evidence  of  being 
influenced  by  the  alcohol.  "  In  three  minutes  after  taking  the 
spirits  and  water,  the  action  of  the  heart  was  increased,  and 
continued  so  for  from  thirty  to  forty  minutes.  This  was  at- 
tended by  a  sense  of  dryness,  heat,  and  evident  fulness  of  the 
exposed  parts  of  the  skin,  as  the  hands  and  feet,  and  also  a 
general  sensation  of  heat.  The  skin  was  as  harsh  and  dry  as 
when  exposed  to  an  easterly  wind.  After  about  twenty  to 
forty  minutes,  tliis  sensation  of  heat  gave  place  to  one  of  cold, 
first  felt  in  the  most  sensitive  parts  of  the  body  in  reference  to 
temperature — ^viz.,  between  the  shoulders,  and  at  length,  not- 
withstanding  the  existence  of  a  suitable  atmosphere,  became 
distressing,  and  led  even  to  shivering.  This  was  sometimes  50 
marked  and  occurred  so  suddenly,  that  it  gave  rise  to  a  shock. 
It  did  not  correspond  with  the  temperature  of  the  skin,  but  it 
was  usually  co-existent  with  the  cessation  of  increase  of  the 
heart's  action." 

In  these  details  we  have  the  action  of  alcohol  on  the  circu- 
lation, and  some  of  the  consequences  thereof  well  delineated. 
The  heart  is  at  first  stimulated  to  increased  activity.  The  blood 
circtdates  in  gieater  volume,  and  with  more  rapidity,  carrjang 
with  it  increased  heat  to  the  surface  and  extremities.  As  its 
primary  influence  passes  off,  the  central  organ  of  the  circulation 
works  less  vigorously,  abnormal  contraction  of  the  capillaries 
follows  their  previously  abnormal  dilatation,  and  the  recently- 
acquired  warmth  of  the  body  gives  place  to  a  sensation  of  cold 
so  considerable  as  to  amount  to  "  shock." 

The  first  indication  of  the  cerebral  organization  being  influ- 

19^ 


292  Observations  on  the  Physiological  and 

enced  by  the  alcohol,  was  felt  by  Dr.  Smith  almost  coin- 
cideiitly  with  increased  cardiac  action,  and  to  the  state  of  the 
circulation  it  was  probably  due.  "A  sensation  of  fulness  at 
the  crown  and  back  part  of  the  head,  or  at  the  temples,  accord- 
ing to  the  kind  of  spirit  taken,"  was  the  first  symptom  of  nervous 
disorder  noticed.  In  from  three  to  seven  minutes  the  mind 
b3came  disturbed.  In  the  words  of  Dr.  Smith, — "  consciousness, 
the  power  of  fixing  the  attention,  the  perception  of  light,  and,  we 
believe,  of  sound  also  were  lessened ;  the  power  of  directing  and 
co-ordinating  the  muscles  was  also  lessened,  whilst  there  was 
a  very  marked  continuous  purring  or  thrilling,  and  not  un- 
pleasant sensation  passing  from  above  downwards  through  the 
whole  system.  Tliis  latter  symptom  was  most  pronounced  in 
from  fifteen  to  forty  minutes,  and  continued  without  much 
variation  during  twenty  to  thirty  minutes.  After  this  period 
the  whole  effect  recorded  under  this  head  diminished,  and 
oftentimes  suddenly,  as  was  shown  by  an  increased  perception 
of  light,  as  if  a  veil  had  fallen  from  the  eyes,  and  by  increased 
consciousness ;  but,  nevertheless,  the  last  power  to  be  completely 
regained  was  consciousness." 

Again,  the  effect  of  alcohol  is  manifested  in  the  mental  con- 
dition induced.  "  Eum  and  some  other  spirits,"  says  Dr.  Smith, 
"  made  us  very  hilarious,  so  much  so  that  my  friend  was  alto- 
gether a  king ;  but  as  minutes  flew  away,  so  did  our  joyousness, 
and  little  by  little  we  lessened  our  garrulity,  and  felt  less  happy, 
until  at  length,  having  gone  down  by  degrees,  we  became  silent, 
almost  morose,  and  extremely  miserable." 

Through  the  medium  of  the  nervous  system,  again,  the 
muscular  apparatus  of  the  body  becomes  disordered.  "The 
thin  layers  of  the  voluntary  muscles  found  about  the  body 
showed  great  relaxation.  The  respiratory  muscles  acted  in  a 
gasping  manner,  so  that  there  was  a  pumping  and  quick  inspi- 
ratory effort  in  the  earlier,  and  a  feeble  expiratory  effort  in  the 
later  stage.  At  aU  periods  there  was  a  sense  of  impediment  to 
respiration."     Though  I  cite  these  symptoms  here  as  evidence 


Therapeutic  Effects  of  Alcohol  293 

of  the  lack  of  nervous  force  induced  by  alcohol,  they  are  but 
partly  due  to  this  cause,  being  probably  the  more  direct  result 
of  that  vitiated,  that  imperfectly  aerated  state  of  the  blood  to 
which  alcohol  gives  rise.  To  continue, — "  The  muscles  of  the 
limbs  were  inactive.  There  was  relaxation  of  the  muscles  and 
stiffness  of  the  skin  of  the  face,  forehead,  and  upper  lip,  so  that 
the  features  fell.  The  state  of  the  muscular  system  followed  the 
commencement  of  the  effect  upon  the  consciousness,  and  other 
functions  of  the  brain,  and  also  the  excited  state  of  the  heart. 
In  reference  to  its  cessation,  the  power  of  co-ordinating  the 
muscles  was  the  first  regained,  whilst  the  buzzing  sensation 
and  semi-cataleptic  state  continued,  and  the  disposition  to  use 
the  muscles  was  regained  the  last  of  alL" 

In  the  earlier  of  the  symptoms  I  have  detailed,  we  find  a 
diminution  in  the  nervous  power  of  the  senses;  a  partial  paraly- 
sis, as  it  were,  of  sight  and  hearing,  accompanied  by  a  general 
excitability  of  the  whole  nervous  system,  as  remarked  in  the 
continuous  purring  and  thrilling  passing  from  above  downwards. 
We  subsequently  saw  a  perversion  of  nervous  energy  in  the 
mental  phenomena  evoked.  The  brain,  the  medium  of  the 
mind,  was  disordered,  and  evinced  its  morbid  state  primarily  in 
excitement,  and  secondarily,  in  depression.  The  former  de- 
pending on  the  increased  activity  of  the  circulation  throughout 
its  substance ;  the  latter  arising  from  the  specific  action  of  the 
alcohol  upon  it,  from  the  depraved  condition  of  the  blood.  The 
spinal  cord,  though  less  powerfully  and  less  permanently  affected 
by  the  alcoholic  fluid,  is,  nevertheless,  very  strikingly  influenced 
by  it,  as  seen  in  the  impaired  power,  if  not  altogether  of 
moving,  at  any  rate  of  co-ordinating  the  action  of  the  muscles. 

In  these  experiments  of  Dr.  Smith  and  his  friend,  we  find 
ample  evidence  of  the  sphere  in  which  alcohol  exhibits  its 
peculiar  influence.  .Physiological  and  pathological  investiga- 
tions point  to  a  similar  direction.  To  some  of  these  researches 
I  will  refer. 

Dr.  Marcet,  in  the  course  of  a  series  of  experiments  detailed 


2'.»4  Observations  on  the  Physiological  ami 

but'oro  the   Hritish  Association  at  its  meeting  at  Aberdeen  in 

185'.»  (Mailed I  Time^  and  Gazette,  March,  1860),  showed  that 

fro<^rs  into  whom  he  had  injected  alcohol  died  more  rapidly  from 

])()isnn(nis  shock,  when  both  the  circulation  and  nervous  com- 

nuiiiieations  were  free  than  when  any  mutilation  of  nervous 

trunks   liad   been  previously  practised.      Thus    demonstrating 

that    the    nerves   themselves    are   conductors   of  the    alcholic 

])()ison;  that  the  nervous  system  is  influenced  in  all  its  parts, 

in  its  tmcts  as  well  as  in  its   centres.     From  an  ingenious 

comparison   between  the  observed    action   of  alcohol   and  an 

experiment    of  M.    Claude   Bernard's,   Dr.   Marcet   infers   the 

nature  of  the  influence  of  alcohol  on  the  sympathetic  system. 

He  remarks,  at  page  13  of  his  work  on  "Alcoholic  Intoxication," 

"  wlien  fermented  beverages  are  taken  in  moderate  quantity,  it 

is  obvious  from  the  increased  rapidity  of  the  circulation  they 

induce  in  the  membranes  with  which  they   come  in  contact, 

that  the  alcoliolic  fluid  exerts  a  local  action  on  the  nerves 

ramifying  in  those  membranes.     It  is  difficult  to  determine  the 

precise  seat  of  this  action,   but  we  may  surmise    that  it  is 

exerted  principally  on  the  sympathetic,  this  system  supplying 

twigs  which  accompany  arteries  into  their  minutest  divisions. 

If  we  now  bear  in  mind  the  facts  revealed  to  us  by  Claude 

Bernard,  that  by  cutting  a  branch  of  the  sympathetic  nerve,  the 

circulation  of  the    part  which  is  supplied  by  that  nerve  is 

greatly  increased,  and  also  that  this  very  same  increased  rate  of 

the  circulation  takes   place  where  alcohol  is  present  in  the 

stomach,  it  is  but  rational  to  conclude  that  alcohol,  when  first 

absorbed  by  the  minutest  blood-vessels,  has  the  property  of 

lessening  the  normal  functions  of  the  sympathetic  nerves  which 

supply  those  vessels."     The  same  observer  has,  in  the  series  of 

experiments  already  alluded  to,  shown  that  the  shock  which  has 

been  known  to  follow  the  sudden  imbibition  of  large  quantities 

of  raw  spirits,  is  due  to  their  direct  action  on  the  extremities 

of  the  cerebro-spinal  nerves.     Thus  in  a  frog,  in  which  the 

circulation    had   been   arrested,    temporary   insensibility    was 


Therapeutic  Effects  of  A  Icohol.  295 

induced  when  the  hind  limbs  were  immersed  in  alcohol,  while 
in  one  where  the  circulation  was  undisturbed,  but  the  nerves  of 
the  limbs  placed  in  alcohol  severed  fi*om  their  centre,  no  shock 
occurred.  Thus  demonstrating  that  in  sudden  shock  the 
impression  is  conveyed  to  the  centre  solely  by  the  nerves  and 
independently  of  the  blood  vessels. 

Again,  there  are  certain  excretions  dependent  partly  on 
changes  in  the  nervous  system,  such  as  the  phosphatic  salts, 
which  are  altered  under  the  influence  of  alcohol.  Dr.  Chambers 
alleges  that  they  are  diminished ;  but,  as  he  never  carried  his 
investigations  beyond  the  primary  stage  of  alcoholism,  and  as 
there  are  many  observations  tending  to  rebut  his  conclusion,  the 
probability  is,  that  when  the  deeper  action  of  the  spirit  comes 
into  play,  these  are  largely  increased.  Some  observers  have 
remarked  a  diminution  in  the  amount  of  ui^ea  excreted  under 
the  influence  of  alcohol ;  others  have  stated  that  it  is  in  excess. 
In  all  likelihood  this  excretion  is  not  changed  in  quantity,  for 
Dr.  Brinton  has  shown  that  when  diminished  in  the  urine  its 
place  has  appeared  to  be  supplied  by  the  large  increase  which 
takes  place  in  the  ammoniacal  constituent  of  the  foeces.  The 
channel  of  excretion,  and  not  the  excretion  itself,  it  is  that  is 
altered. 

While  pathogenetic  and  physiological  experiments  show  the 
power  of  alcohol  over  the  nervous  system,  pathological  investi- 
gations tend  to  the  same  result. 

Dr.  Ogston,  of  Aberdeen,  in  1833  detected  alcohol  in  the 
ventricles  of  the  brain  of  a  person  who  had  died  in  a  state  of 
intoxication.  Dr.  Percy  was  led  by  a  similar  observation  to  a 
more  extended  series  of  experiments,  the  thesis  in  which  they 
were  published  obtaining  an  Edinburgh  University  gold  medal. 
He  procured  alcohol  from  the  brains  of  intoxicants  by  distilla- 
tion. And,  though  he  detected  it  by  the  same  means  in  the 
liver  and  the  kidney,  it  was  in  the  brain  that  he  found  the 
largest  proportion. 

The    mode  of  death  from  alcohol  points    to  the   nervous 


296  Observations  on  the  Physiological  and 

system  as  that  upon  which  its  lethal  influence  has  been  chiefly 
exerted. 

Death,  as  I  have  already  noticed,  sometimes  occurs  suddenly 
from  nervous  shock,  after  the  ingestion  of  a  large  quantity  of 
spirit.  In  a  dog  into  whose  stomach  Dr.  Percy  injected  two 
ounces  and  a-half  of  alcohol  death  was  instantaneous.  But,  speedy 
as  was  the  fatal  result  in  its  occurrence,  alcohol  was  found  in  the 
brain  in  a  quantity  equal  to  that  which  on  previous  occasions 
had  been  yielded  when  the  alcohol  had  had  much  longer  time 
to  accumulate. 

In  cases  where  death  supervenes  more  gradually,  the 
symptoms  are  traceable  not  merely  to  nervous  derangement,  but 
also  to  deficient  aeration  of  the  blood.  Coma,  convulsions, 
apoplexy,  and  asphyxia  constitute  the  more  prominent  features 
in  persons  dying  of  alcoholic  poisoning.  An  interesting  and 
instructive  case  of  this  nature,  illustrating  alike  the  rapid 
absorption  of  alcohol,  and  the  direction  of  its  action  is  recorded 
by  the  late  Dr.  Todd  in  his  "Clinical  Lectures  on  Acute 
Diseases  "  (p.  44,  1st  ed.)  A  child,  three  years  old,  was  brought 
into  King's  College  Hospital  in  a  comatose  state,  having,  about 
six  hours  previously,  had  about  a  half-a-quartem  (two-and-a-half 
ounces)  of  gin  administered  to  it.  Coma  supervened  soon  after 
the  gin  was  taken ;  and  when  admitted  she  was  still  insensible, 
though  the  pulse  was  good,  the  body  and  extremities  warm, 
and  the  eyes  presenting  a  natural  appearance.  Emetics — the 
cold  douche  to  the  head,  a  mustard  and  water  bath,  slapping 
the  feet  and  posteriors,  were  tried  with  the  view  of  arousing 
her,  but  produced  no  effect  beyond  crying  and  kicking,  hit  with 
the  right  leg  only.  The  left  arm  and  leg  were  paralysed.  Three 
hours  after  admission  an  epileptic  fit  occurred,  with  convulsive 
twitchings  of  the  left  side  of  the  body  and  face.  The  right 
side  shared  also  in  the  convulsions,  but  only  to  a  slight  extent. 
About  twenty  or  thirty  paroxysms  of  this  character  took  place 
during  the  night,  the  intervals  being  passed  in  a  comatose 
state.     In  three  more  days  the  patient  sank  exhausted,  the 


Therapmtic  Effects  of  Alcohol  297 

paralysis  having  continued  unaltered,  and  on  one  occasion 
only,  on  the  day  before  her  death,  did  she  exhibit  any  sign  of 
consciousness.  The  brain  presented  an  extreme  degree  of 
pallor;  but,  beyond  this,  there  was  no  abnormal  anatomical 
condition,  either  of  its  grey  or  white  substance ;  neither  was 
there  any  effusion  into  its  cavities,  nor  any  condition  by  which 
coma  could  be  accounted  for  by  way  of  pressure.  The  only  other 
alteration  observable,  beyond  the  congestion  of  the  lower  lobes 
of  the  lungs,  was  some  degree  of  fatty  degeneration  of  the 
kidney.  The  result,  in  all  probability.  Dr.  Todd  remarks,  of 
previous  mal-nutrition.  In  this  case  it  will  be  seen  that  there 
was  no  cerebral  congestion,  no  structural  lesion  to  explain  the 
severe  nervous  shock  that  brought  life  to  a  close.  The  power 
of  the  brain  to  create  nervous  force  was  simply  obliterated, 
more  completely  so  in  one  hemisphere  than  in  the  other.  For 
lack  of  the  nervous  energy  supplied  by  the  brain  the  patient 
died. 

While  the  paralysis  and  nervous  irritation  exemplified  by 
this  and  similar  cases  are  due,  in  a  very  considerable  degree,  to 
the  elective  affinity  for  alcohol  possessed  by  the  brain,  the 
morbid  condition  of  the  blood  engendered  by  the  excessive  use 
of  spirits  plays  an  important  part  in  the  production  of  the  con- 
ditions upon- which  such  disordered  states  depend.  The  rapid 
absorption  of  alcohol  by  the  blood  noticed  in  Dr.  Todd's  case 
has  been  remarked  upon  by  all  who  have  studied  its  action. 
Dr.  Percy  in  his  experiments  found  the  darkened  arterial  blood 
of  a  dog  to  yield  alcohol  in  distillation.  But  not  only  is  it 
thus  absorbed,  and  so  conveyed  to  the  brain  and  other  organs 
upon  which  it  exerts  its  most  marked  influence,  but  its  pre- 
sence alters  the  constitution  of  the  blood.  Dr.  Boecker  found 
on  comparing  the  blood  of  a  person  who  never  took  alcohol  in 
any  form  with  that  of  one  who  took  daily  a  certain,  but  not 
excessive,  quantity  of  brandy,  that  in  the  latter  the  organic 
constituents  were  deficient ;  the  proper  amount  of  fibrine  as 
compaied  with  albumen  was  wanting ;  the  red  clot  was  more 


298  Observations  on  the  Physiologhdl  and 

carbonized,  or,  at  least,  blacker  than  in  health.  The  pale  and 
colourless  corpuscles  were,  he  observes,  in  excess.  To  this 
source  probably  may  be  traced  the  dark  colour  of  the  clot 
rather  than  to  its  admixture  with  carbon.  The  colourless 
corpuscles  are  simply  undeveloped  red  blood  discs.  They  do 
not  become  coloured  on  reacliing  the  hmgs,  and  hence  the 
blood  itself,  and  consequently  the  clot  formed  from  it,  are  dark 
in  colour.  The  experiments  of  Bourchardat  and  Sandras  are 
confirmed  by  those  of  Boiicker.  They  found  the  arterial  blood 
in  a  person  under  the  influence  of  alcohol  to  have  all  the 
characters  of  venous  blood — to  be  evidently  unoxidated.  In 
commenting  upon  the  investigations  of  Boecker,  Dr.  Chambers 
remarks  "  that  the  blood  is  less  vitalized,  is  anemic,  and  at 
the  same  time  too  venous,  too  much  in  the  condition  of  the 
portal  system  ;  it  retains  too  much  of  the  efiPete  matter,  and  is 
deficient  in  new  active  globules"  ("Digestion  and  its  Derange- 
ments," p.  231). 

The  observations  I  have  here  adduced  afford  no  evidence,  I 
may  remark  in  passing,  of  the  decomposition  of  alcohol  within 
the  circulation.  On  the  contrary,  it  was  obtained  from  it  by 
distillation  by  Dr.  Percy ;  while  its  dark,  carbonized  looking 
condition,  was  due  not  to  its  having  obtained  an  excess  o 
caj.'bon  from  an  unusual  source,  but  from  that  which  it  normallj 
contained,  deprived  from  efiPete  matters,  not  having  been  elimi 
nated.  Dr.  Smith's  experiments  on  the  influence  of  alcohol 
on  the  respiratory  process  go  to  confirm  the  hypothesis.  He 
found,  he  tells  us,  that  the  respiration  was  "  disturbed  rathei 
than  materially  altered  "  ("  Philosophical  Transactions,  1859") 
The  respiratory  movements  were,  he  says,  in  all  instances,  ex- 
cept where  porter  was  the  alcoholic  fluid  used  in  experimenting 
diminished  in  frequency.  The  carbonic  acid  excreted  by  th( 
lungs  was  diminished  when  whiskey,  brandy,  gin,  and  sherrj 
were  taken.  When  pure  alcohol  was  used,  it  was  increased  tc 
nearly  one-fifth  of  a  grain  per  minute,  the  nonnal  amount  being 
eight  and  four-fifths  of  a  grain  per  minute.     With  rum,  rum  and 


Therapeutic  Effects  of  A  Icohol.  299 

milk,  stout,  and  ale,  it  was  more  decidedly  increased.  The  re- 
sults probably  of  the  large  amount  of  saccharine  matter  con- 
tained in  these  compounds.  Dr.  Prout,  in  experiments  made 
with  the  same  end  in  view  as  Dr.  Smith's,  found  that  the 
carbonic  acid  was  excreted  in  diminished  quantity,  but  that 
after  the  lapse  of  two  or  three  hours  from  the  time  the  alcohol 
was  taken,  it  was  very  considerably  increased. 

That  the  blood  contains  an  excess  of  carbon,  whether  de- 
rived from  the  alcohol,  or  consisting  of  that  which  in  the 
usual  order  of  healthy  changes  ought  to  have  been  extruded 
from  the  system,  is  certain.  This  fact  is,  in  some  degree, 
illustrated  by  two  symptoms  noted  by  Dr.  Smith.  He  says, 
"the  respiratory  muscles  acted  in  a  gasping  manner,  so  that 
there  was  a  pumping  and  quick  expiratory  eflfort  in  the  earlier, 
and  a  lazy  feebler  expiratory  effort  in  the  later,  stages."  And 
again  he  remarks,  "  at  all  periods  there  was  a  sense  of  impedi- 
ment to  respiration."  That  such  is  the  condition  of  the  blood 
is  still  further  corroborated  by  two  cases  of  spasm  of  the  glottis, 
arising  from  an  excessive  use  of  alcohol ;  the  one  is  reported 
in  the  Medico-Cliirurgical  Transactions  for  1837,  and  the 
other  in  the  Ediriburgh  Medical  and  Surgical  Journal  for  1833, 
and  both  are  re-produced  in  Dr.  Marcet's  work  previously  re- 
ferred to  (p.  20).  The  former  recovered  after  tracheotomy;  the 
other  was  fatal  In  the  first,  the  respiration  had  a  shrill  tone 
and  was  extremely  difficult — ^the  patient  was  perfectly  comatose. 
Tracheotomy  was  followed  by  an  immediate  cessation  of  the 
violent  efforts  of  the  respiratory  muscles,  and  the  subsidence  of 
the  venous  distension  around  the  head  and  neck.  In  half  an 
hour  the  breathing  was  regular.  In  the  second,  the  post 
mortem  appearances  showed  that  "  both  lungs  were  congested 
with  dark  fluid  blood ;  dark  blood  was  found  in  the  ventricles 
of  the  heart ;  the  blood  of  the  veins  generally  was  fluid  and 
dark  coloured."  The  symptoms  in  both  cases,  and  the  post 
mortem  appearances  in  one,  resembled  those  in  cases  of  asphyxia, 
from  the  presence  within  the  circulation  of  some  gaseous  poison. 


30  0  Observations  on  the  Physiological  and 

Here,  probably,  they  may  be  assigned  to  three  causes,  the 
common  results  of  alcohol, — First,  to  deficient  innervation  giving 
rise  to  a  feeble  semi-paralysed  state  of  the  muscles  of  respira- 
tion. Secondly,  to  the  retention  within  the  blood  of  that  carbonic 
acid  which  ought  to  have  passed  off  in  respiration.  And, 
Thirdly,  to  the  "  presence  of  alcohol  within  the  circulation  by 
interfering  with  or  checking  the  action  of  air  in  the  blood 
within  the  circulation  giving  rise  to  a  morbid  condition  incom- 
patible with  the  maintenance  of  life"  (Marcet,  op.  cit,  p.  25). 

From  the  facts  I  have  now  laid  before  you,  we  may,  I  think, 
conclude  that  alcohol  has  the  property,  first,  of  deteriorating  the 
quality  of  the  blood ;  secondly,  from  this  cause,  and  also  by  virtue 
of  the  affinity  which  nervous  and  especially  cerebral  matter  has 
for  it,  it  gives  rise  to  a  narcotised  state  of  the  brain  in  par- 
ticular, and  of  the  nervous  system  in  general ;  and,  thirdly,  that 
it  is  conveyed  through  the  body  both  in  the  circulation  and 
along  the  nerves. 

Eeceived  into  the  blood,  altering  its  physical  constitution, 
and  impairing  nervous  power,  alcohol  must  influence  in  a 
greater  or  less  degree  every  organ  of  the  body ;  and  we  find 
that  it  does  so. 

From  the  liver  alcohol  has  been  distilled  where  death  has 
occurred  during  intoxication.  By  its  presence  in  this  organ, 
the  structure  is  directly  irritated,  while  its  functional  activity 
is  abnormally  increased  by  the  deficient  power  of  the  respira- 
tion. The  effete  matters,  which  we  have  seen  to  be  retained 
in  the  circulation,  not  being  passed  off  at  the  lungs,  are  thrown 
upon  the  liver.  The  ultimate  result  of  this  physical  and 
physiological  excitement  is  undue  and  irreparable  waste  of 
tissue.  Contraction,  therefore,  takes  place.  In  other  cases, 
where  the  alcoholic  beverage  indulged  in  contains  a  considerable 
quantity  of  saccharine  matter,  fatty  degeneration  of  the  struc- 
ture ensues.  The  accumulation  of  this  morbid  material  gives 
an  appearance  of  bulk ;  the  organ  is  said  to  be  hypertrophied. 
In  reality,  its  size  is  diminished ;  the  fat  giving  to  it  its  ap- 


Therapeutic  Effects  of  A  IcohoL  301 

parent  enlargement,  being  in  part  derived  from  a  change  in  a 
decay  of  its  natural  tissues. 

On  the  stomach  alcohol  acts  mainly,  first,  as  a  topical  irri- 
tant ;  and,  secondly,  as  a  paralyser  of  its  nervous  supply. 

Passing  unchanged  through  the  kidney,  it  excites  a  degree  of 
congestion,  depending,  as  in  the  liver,  partly  on  its  irritating 
character,  and  partly  on  the  excess  of  functional  activity  de- 
manded by  blood  containing  alcohoL  From  the  urine  of  per- 
sons who  have  recently  taken  spirits,  alcohol  has  been  obtained 
in  a  more  or  less  notable  quantity. 

To  one  other  series  of  experiments  do  I  wish  briefly  to  allude 
before  passing  to  notice  the  theories  offered  to  account  for  the 
mode  of  action  of  alcohoL     I  refer  to  the  investigations  of 
Messrs.  Lallemand,  Perrin,  and  Duroy,  and  their  recently  pub- 
lished counterpart,  the  experiments  of  M.  Baudot.      I  have 
already  shown  that  alcohol  is  deposited  in  various  organs,  and 
that  it  is  thrown  out  from  the  system  through  the  renal  secre- 
tion.     Dr.   Edward   Smith   has   demonstrated  its    extrusion 
through  the  skin.     Messrs.  Lallemand,  Perrin,  and  Duroy  have, 
in  an  academical  prize  essay,  proved  that,  in  addition  to  these 
channels  of  elimination,  it  is  passed  off  in  respiration,  and  that 
it  can  be  detected  in  the  breath  some  hours  after  having  been 
drank.     By  experimenting  upon  the  various  products  of  excre- 
tion, they  recovered  about  28  per  cent,  of  the  alcohol  that  had 
been  taken.     Finding  no  evidence  whatever  of  the  conversion 
of  the  remaining  72  per  cent.,  they  conclude  that  it  escaped 
from  the  economy  in  a  similar  manner  to  that  which  they 
secured,  but  that  owing  to  the  imperfection  of  chemical  appli- 
ances, the  length  of  time  elapsing  before  the  whole  of  the 
alcohol  is  extrudefi,  and  other  sources  of  error  in  calculation, 
they  failed  in  its   detection.     These  experiments'  have  lately 
been  called  in  question  by  M.   Baudot  in  a  series  of  papers 
published  in  i'  Union  MMicale.     M.  Baudot,  it  appears,  failed 
to  discover  any  very  appreciable  quantity  of  alcohol  either  in 
the  breath,  the  perspiration,  or  the  urine,  and  hence  asserts  the 


302  Observations  on  the  Physiological  and 

conversion,  or  oxidation  of  alcohol  within  the  body.  M.  Perrin 
defends  tlie  experiments  contained  in  the  work  of  which  he 
Avas  a  joint  autlior;  endeavours  to  show  why  he  and  his  col- 
leagues did  not  find  more  of  the  alcohol  taken  than  they  did ; 
adduces  a  series  of  arguments  to  prove  that  alcohol  is  not  an 
aliment,  and  points  out  what  he  considers  its  uses  and  value. 

From  tlie  observations  of  Ogston,  Percy,  and  others  in  this 
country,  and  the  French  authors  just  named,  we  gather  that 
alcohol  accumulates  in  several  organs,  more  particularly  in  the 
brain  and  liver;  that  it  remains  in  the  system  for  a  certain 
length  of  time,  this  depending  probably  on  the  amount  taken, 
the  circumstances  under  which  it  is  taken,  and  the  individual 
powers  of  re-action ;  that  during  its  retention  it  gives  rise  to 
certain  functional  changes,  producing,  according  to  their  in- 
tensity and  duration,  more  or  less  alteration  of  structure ;  and 
that,  ultimately,  a  great  portion,  if  not  the  whole,  is  expelled 
from  the  organism  through  its  several  emunctories.  Dr. 
Marcet  is  of  opinion  "  that  a  large  portion  of  the  alcohol  con- 
sumed by  habitual  drinkers  is  not  at  all  absorbed  by  the  blood, 
but  that,  after  undergoing  certain  chemical  changes,  it  is  elimi- 
nated through  the  intestines  with  the  other  excreta  "  (pp.  cit, 
p.  1 9).  Possibly  a  considerable  portion  of  that  which  escaped 
the  notice  of  the  French  observers  may  have  passed  off  in  this  way. 

Such  are  the  principal  well  ascertained  and  clearly  established 
facts  regarding  the  action  of  alcohol  on  the  animal  economy. 
By  the  light  wliich  they  afford  must  we  be  guided  in  attempt- 
ing to  deteimine  the  character  of  this  action,  and  from  them 
must  we  learn  when  and  where  the  selection  of  alcohol,  as  a 
remedy,  will  best  avail  us  in  our  efforts  to  check  the  advance 
or  prevent  the  occurrence  of  disease.  I  believe  the  details  I 
have  advanced  are  perfectly  competent  for  the  attainment  of 
tliese  two  ends.  For,  though  nearly  all  the  symptoms  observed, 
all  the  pathological  changes  noted,  and  all  the  results  of  physio- 
logical investigations  that  have  accrued,  either  from  unusually 
considerable  doses  of  alcohol,  or  from  smaller  ones  taken  under 


Therajpeutic  Effects  of  A  IcolioL  303 

somewhat  exceptional  circumstances,  still,  as  Dr.  Edward 
Smith  remarks,  "  the  dose  only  affects  the  degree  and  not  the 
direction  of  its  influence."  As  with  all  drugs,  so  with  alcohol, 
it  is  with  the  direction  of  its  action  that  we  are  mainly  concerned. 

Several  theories  explanatory  of  the  action  of  alcohol  have 
been  advanced.  By  some  it  is  supposed  to  be  a  Food.  Those 
who  have  regarded  it  in  this  light  have  endeavoured  to  show 
that  it  affords  material  for  the  maintenance  of  animal  heat ;  that 
it  is  the  nutrient,  par  excellence,  of  nervous  matter,  and  that  it 
is  a  source  of  the  supply  of  fat. 

Liebig,  in  his  well  known  work  on  Animal  Chemistry  wdiS,  I 
believe,  the  first  who  assigned  to  it  the  property  of  maintaining 
animal  heat.  Assuming  that,  when  received  into  the  stomach 
and  absorbed  by  the  blood  vessels,  it  was  there  decomposed  into 
its  chemical  elements,  he  inferred  that  the  large  amount  of 
carbon  and  hydrogen  thus  supplied  united  with  the  oxygen  of 
the  atmosphere  to  form  carbonic  acid  gas  and  water,  and  that 
this  union,  or  combustion  of  carbon  and  hydrogen,  gave  rise  to 
heat.  That  in  fact  alcohol  was  burnt  off  in  the  function  of 
respiration.  This  theory,  it  will  be  at  once  obvious,  is  one  purely 
chemical  in  its  basis ;  one  wliich  omits  all  consideration  of  the 
physiological  action  of  the  spirit.  The  fallacy  of  the  doctrine 
lies  in  the  assumption  that  decomposition  takes  place  after  the 
fluid  has  entered  the  circulation.  No  such  change  has  ever 
been  demonstrated ;  while,  on  the  other  hand,  the  experiments 
of  Messrs.  Lallemand,  Perrin,  and  Duroy,  with  those  of  Dr. 
Edward  Smith,  tend  to  show  that  alcohol,  so  far  from  being 
decomposed,  escapes  from  the  system  in  its  original  state.  And, 
again,  were  it  a  fact  that  it  was  resolved  into  its  chemical 
elements,  and  burnt  off  at  the  lungs,  the  carbonic  acid  evolved 
during  respiration  should  certainly  be  in  very  considerable 
excess  over  its  normal  proportions.  But  Dr.  Smith  has  con- 
clusively proved  that  no  such  excess  can  be  detected.  Is  it, 
howeiver,  true  ?  Does  practical  observation  show  that  heat  is 
developed  by  means   of  alcohol?      The  experience  of  arctic 


3  04  Observations  on  the  Physiological  and 

travellers — so  repeatedly  quoted  as  to  render  specific  reference 
unnecessary — has  shown  that  the  severe  cold  of  the  regions  in 
which  they  sojourned,  was  better  borne,  was  less  felt,  when 
spirits  were  abstained  from  than  when  indulged  in.  Dr.  John 
Davy  tells  us  that,  both  in  England  and  the  Barbadoes,  he 
found  wine  to  have  a  positively  depressing  influence  on  the 
temperature  of  the  body — a  depression  which  increased  in  pro- 
portion to  the  amoimt  of  stimulant  taken.  Dr.  Edward  Smith 
concludes  from  his  investigations  that  "  alcohol  does  not  increase 
the  production  of  heat  by  its  own  chemical  action,  but  in- 
directly," by  lessening  the  action  of  the  skin,  and  thereby 
reducing  the  loss  of  heat.  Ultimately,  however,  in  its  secon- 
dary action  "  it  varies  the  balance  of  the  circulation  at  the 
centres  and  superficies,  and  interferes  with  the  production  of 
heat."  These  facts  appear  to  me  to  entirely  negative  Liebig*s 
theory,  and  to  show  that  the  sense  of  heat  following  the  use  of 
alcohol  is  similar  in  many  points  to  that  resulting  from  fever, 
giving  place,  after  its  primary  action  has  passed  away,  to  a 
sense  of  chilliness  far  more  persistent  than  the  previous  warmth. 
Secondly,  by  the  late  Dr.  Todd  and  others,  alcohol  has  been 
supposed  to  be  a  special  nutrient  of  the  nervous  system.  Here, 
again,  the  basis  of  the  argument  is  found  in  its  chemical  con- 
stitution. "  Alcohol  is,  as  you  are  aware,"  says  Dr.  Todd,  "  a 
hydrocarbon;  aud  almost  all  hydrocarbons  have  a  marked 
affinity  for  the  nervous  system  compared  with  the  other 
structures  of  the  body,  and  it  is  upon  the  nervous  centres  that 
alcohol  exerts  its  primary  influence.  At  first  its  action  is 
simply  to  augment  nervous  power"  {op,  cit,  p.  455).  True  it 
is  that  alcohol  exerts  its  primary  influence  upon  the  nervous 
system,  but  this  influence  is  very  far  removed  in  its  nature  from 
that  of  a  nutrient.  Dr.  Smith  remarks  that  "  there  is  no  evi- 
dence that  it  increases  nervous  influence,  except  the  action 
upon  the  heart  and  the  elevation  of  the  spirits  be  r^arded  as 
such ;  whilst  there  is  much  evidence  that  it  lessens  the  nervous 
power,  as  shown  by  the  mind  and  the  muscles."     All  physio- 


Therapeutic  Effects  of  A  IcohoL  305 

logical  investigations,  all  pathological  studies  tend  to  show  that 
it  is  deterioration  not  generation  of  healthy  nervous  force  that 
results  from  the  affinity  of  alcohol  for  cerebral  matter. 

The  supposition  that  alcohol  loads  the  blood  with  fat 
globules,  the  fact  that  the  chemical  composition  of  alcohol  and 
fat  are  allied  to  that  of  nervous  structures,  and  the  known 
narcotic  property  of  spirits,  have  led  Dr.  Eutherfurd  Eussell  in 
his  very  interesting  and  practically  useful  Essay  on  "  Diet'*  to 
infer  the  probability  of  its  nourishing  and  cherishing  the  ner- 
vous System.  In  answer  to  these  three  reasons  on  which  the 
theory  is  advanced,  it  may  be  urged, — first,  that  the  globules 
seen  in  the  blood  which  have  been  supposed  to  be  fatty  are,  in 
reality,  imperfectly  formed  red  corpuscles.  The  highest  stage 
of  the  blood  globule  being  prevented  development  by  the 
circulation  of  alcohoL  In  the  second  place,  the  chemical 
likeness  existing  between  fat,  alcohol,  and  brain  would  be 
fair  evidence  enough  of  the  power  of  the  two  former  to  sup- 
ply nutriment  to  the  last,  if  supported  by  physiological  proof 
that  the  brain  was  nourished  by  spirits,  wine,  or  beer,  but 
standing  alone,  imsupported  by  physiological  evidence,  it  is 
valueless  in  interpreting  the  action  of  alcohoL  Thirdly,  the 
narcotic  effect  of  alcohol  is  simply  one  of  its  poisonous  results. 
During  healthy  normal  sleep  the  wearied  brain  is  nourished,  is 
re-invigorated.  But  who  will  contend  that  the  same  desirable 
end  is  attained  during  the  narcotism  of  alcohol,  of  opium,  or  of 
chloroform  ?  Will  sleep  so  induced  avert  the  "  nervous  starva- 
tion "  which.  Dr.  EusseU  quotes  Dr.  Buckmll  to  show,  gives 
rise  to  insanity  ?  On  the  contrary,  it  is  the  frequent  occur- 
rence of  the  alcoholic  and  the  opiate  coma,  that  in  a  large 
proportion  of  instances  gives  rise  to  this  fearful  disease. 

Alcohol  does  most  certainly  modify  nervous  action,  but  it 
cannot  nourish  nervous  matter,  or  for  more  than  a  very  brief 
period  elicit  nervous  power. 

The  theory  that  alcohol  is  a  source  of  fat  appears  to  have 
taiaea  from  its  hydrocarbonaceous  composition,  and  from  the 

20 


306  Observations  on  the  Physiological  and 

fact  that  persons  in  the  habit  of  indulging  largely  in  beer, 
porter,  and  some  of  the  richer  wines,  exhibit  a  tendency  to 
obesity.  Such  a  condition  is,  however,  not  necessarily,  nor, 
indeed,  probably,  due  to  the  alcohol  they  contain,  but  rather  to 
their  saccharine  elements.  Such  persons  usually  live  well  in 
other  respects.  The  drinker  of  whiskey  and  gin,  where  alcohol 
exists  in  greater  freedom  from  purely  nutrient  substances,  is  a 
thin,  spare,  and  oftentimes  prematurely  aged-looking  person. 
But  where  fat  is  deposited,  is  its  presence  a  manifestation  of 
superior  vitality  ?  Certainly  not.  It  exists  "  not  in  addition 
to  but  instead  of,  the  normal  tissues  "  {Carpenter),  It  is  found 
chiefly  encumbering  the  liver,  occupying  the  place  of  its  healthy 
structure,  and  also  in  the  omentum.  The  deposition  of  fat  in 
these  cases  is  an  instance  of  fatty  degeneration,  rather  than  of 
strong  robust  health.  How  rapidly  do  such  subjects  succumb 
to  acute  diseases;  especially  to  those  where  the  blood  is 
poisoned  by  the  taint  of  typhus,  small  pox,  and  erysipelas. 
The  London  publicans,  draymen  and  others,  may  be  large  and 
to  a  great  extent — depending,  however,  on  the  amount  of 
physical  exertion  they  undergo— powerful  men ;  but  they  are 
not  types  of  health. 

"  Food,"  liebig  remarks  in  his  Letters  on  Animal  Chemistry 
(p.  479,  4th  ed.,)  ''should  exert  neither  a  chemical  or  peculiar 
action  over  the  healthy  frame."  Judged  by  this  standard 
alcohol  certainly^  is  not  food.  There  is  no  evidence  to  show 
that  it  is  a  supporter  of  animal  heat ;  there  is  none  to  prove 
that  it  nourishes  the  nervous  system ;  and  though  some  alco- 
holic fluids,  by  virtue  probably  of  their  other  contents,  do  tend 
to  an  unhealthy  accumulation  of  fat  in  some  parts  of  the  body^ 
there  is  no  reason  for  attributing  to  alcohol  itself  the  power  of 
adding,  by  the  production  of  fat,  to  the  nutrition  of  the  tissues. 

By  virtue  of  its  power  to  destroy  life  alcohol  may  be  justly 
regarded  as  a  poison,  and  as,  in  the  language  of  Dr.  Taylor, 
''  medicine  in  a  large  dose  is  a  poison,  and  a  poison  in  a  small 
dose  a  medicine ; "  it  must  for  all  practical  purposes  be  treated 


Therapeutic  Effects  of  Alcohol.  307 

as  a  medicine.  It  is  an  agent  capable  of  producing  certain 
morbid  conditions,  a  medicine  remedial  of  disease,  and  not  in 
any  way  a  substance  competent  to  afford  pabulum  for  tlie 
growth  of  animal  tissues.  In  short,  while  it  fulfils  all  the  re- 
quirements of  a  medicine  of  great  value,  it  presents  no  chara- 
teristic  of  a  food. 

From  its  primary  stimulating  action  on  the  circulation,  and 
its  secondary  depressing  influence  on  the  nervous  system,  it 
holds  a  place  in  the  current  Materia  Medica  as  a  stimulant- 
narcotic  ;  and,  in  accordance  with  the  conditions  supposed  to 
indicate  the  necessity  for  such  a  dnig,  it  has  generally  been 
prescribed. 

More  definite  explanations  of  its  modus  operandi  have  been 
attempted.  Two  theories  have  been  made  especially  prominent ; 
these  I  will  briefly  describe. 

Dr.  Chambers,  Dr.  Hammond^  Dr.  Ludlam,  and  others  regard 
alcohol  as  an  arrester  of  metamorphosis.  That  an  arrest  of 
the  normal  waste  of  tissue  takes  place  in  health  is,  however, 
rendered  very  improbable  by  the  experiments  of  Dr.  Smith,  as 
well  as  by  those  other  consequences  of  using  alcohol  I  have 
already  detailed.  Dr.  Chambers  draws  his  conclusions  from 
very  slight,  and  for  all  practical  purposes  useless,  experiments 
of  his  own,  and  from  a  more  careful  series  of  observations  by 
Dr.  Hammond,  of  the  Federal  Army,  in  the  American  States. 
In  all  these  experiments  the  supposed  arrest  of  destructive 
metamorphosis  was,  within  a  brief  period,  followed  by  critical 
evacuations.  A  result  which  proves  that  the  changes  assumed 
to  have  been  checked,  in  reality  occurred ;  but  that  the  debris, 
instead  of  being  cast  out  of  the  system  in  the  several  excre- 
tions, was  retained  within  the  circulation  for  a  time  to  be  cast 
forth  when  reaction  set  in.  As  all  the  investigations  of  Dr. 
Chambers  were  brought  to  a  summary  conclusion,  when  the 
appetite  was  spoiled,  or  the  usual  diet  was  prevented  being 
taken  with  pleasure,  we  cannot  from  them  show  that  these 
changee,  besides  occurring,  were  in  reality  increased ;  but  the 

20* 


308  OhservoUions  on  the  Physiological  and 

observations  of  others  lead  us  to  infer  that  they  were  sa 
Healthy  metamorphosis  requires  for  its  complete  performance  a 
healthy  blood  blastema,  a  healthy  state  of  the  nervous  system, 
and  a  normal  development  of  nervous  power.  These  condi- 
tions are  absent  in  a  man  whose  blood  is  charged  with  al- 
cohoL  Healthy  metamorphosis  is,  therefore,  impossible;  and 
all  lengthened  experiments  tend  to  show  that  the  unhealthy 
metamorphosis  induced  takes  the  form  of  an  excessive,  not  of  a 
diminished,  waste. 

Dr.  Beale,  (British  Medical  Journal,  October  10th,  1863)* 
holds  that  "  alcohol  does  not  act  as  a  food ;  does  not  nourish 
tissue,"  as  his  late  distinguished  colleague  Dr.  Todd  maintained 
that  it  did,  but  that  by  "  altering  the  consistence  and  chemical 
properties  of  fluids  and  solids,"  it  checks  that  "  increased  ac- 
tivity of  the  vital  changes "  which  he  regards  as  characteristic 
of  many  morbid  processes.  Such  being  those  which  take  place 
in  exhausting  diseases,  where,  as  in  the  formation  of  pus,  cancer 
and  the  granular  cells,  a  large  amoimt  of  pabulum  intended  for 
the  nourishment  of  healthy  tissue  is  rapidly  wasted.  There  is, 
it  will  be  seen,  comparatively  little  difference  between  the 
views  of  Dr.  Chambers,  and  those  of  Dr.  Beale.  The  latter 
generalises  from  the  effects  which  he  has  seen  to  follow  the 
prescription  of  alcohol  in  disease;  entirely  ignoring  its  action  on 
the  healthy  man.  Such  a  mode  of  determining  the  nature  of 
drug  action  must  always  be  unsatisfactory,  and  very  generally 
unsound  in  its  conclusions. 

In  health  alcohol  produces  as  its  specific  effect  an  abnormal 
waste  of  nervous  tissue ;  the  expenditure  of  nervous  power  is 
greater  than  normal  metamorphosis  can  meet.  This,  I  think, 
the  observations  and  experiments  I  have  laid  before  you  this 
evening  fully  sustain.  Further,  all  clinical  experience  teaches 
that  the  sphere  of  alcohol  in  disease  is  to  be  found  where 
nervous  exhaustion,  undue  waste,  or  expenditure  of  nervous 
power  are  the  prominent  indications  of  danger.  To  such 
morbid   states  alcohol  is  therefore   manifestly  Homoeopathic. 


Therapeutic  Effects  of  Alcohol.  309 

Its  mode  of  action  is  simply  that  of  all  tme,  direct,  specific 
remedial  agents.  Nor  has  this  similarity  between  the  symptoms 
arising  horn  alcohol  used  in  health,  with  those  for  the  cure  of 
which  it  is  so  generally  prescribed,  been  altogether  overlooked. 
Curiously  enough  it  is  in  the  writings  of  Dr.  Brinton — a 
gentleman  who  seldom  fails  to  seize  an  opportunity  of  sneering 
at  Homoeopathy — that  we  find  the  Homoeopathicity  of  the 
action  of  alcohol  most  clearly  asserted!  Discoursing  on  al* 
coholics  in  his  work  on  Diseases  of  the  Stomach  (p.  378),  Dr. 
Brinton  remarks,  *'  in  short  they  are  sometimes  useftd  remedies 
against  the  very  ailments  which  their  abuse  (or  even  their 
moderate  use)  can  otherwise  bring  about;  a  statement  which," 
and  mark  the  words,  ''while  it  involves  no  inherent  improba- 
hility  rests  upon  an  empirical  basis  such  as  defies  disproof." 

Regarded,  then,  in  what  I  have  endeavoured  to  prove  its 
true  light— as  a  medicine — ^to  be  used  on  the  same  principle 
as  all  others  should  be — as  a  Homoeopathic  remedy — we  shall 
find  the  sphere  of  alcohol  in  those  cases,  or  rather  parts  of  cases, 
where  the  indications  of  danger  arise  from  exhaustion  pro- 
ceeding ficom  an  overstraining  of  the  powers  of  the  nervous 
system.  An  ordinary  fainting  fit  is  a  fair  type  of  such.  A 
sudden  shock  or  prolonged  drain  upon  this  portion  of  the  or- 
ganism gives  rise  to  rapid  and  extreme  waste  of  nervous  force, 
with  quickened  but  depressed  circulation.  In  softening  of  the 
brain  similar  special  waste  is  going  on ;  upon  it  likewise  de- 
pends the  exhaustion  horn  protracted  lactation,  from  long  con- 
tinued diarrhoea,  ficom  hemorrhage,  as  weU  as  that  witnessed  in 
the  later  stages  of  fever,  where  the  heart's  feeble  impulse,  and 
the  low  muttering  delirum,  with  it  may  be  profuse  perspirations, 
point  to  the  nervous  centres  as  rapidly  giving  way.  In  each 
of  these  instances,  many  other  might  be  quoted,  alcohol  is  in- 
dicated as  the  most  probably  curative  remedy,  because  it  pro- 
duces a  condition  similar  to  that  to  be  removed.  Let  me  not, 
however,  be  misunderstood;  I  do  not  say  that  alcohol  is 
Homoeopathic  to  diarrhoea,  and  the  other  diseases  named,  but 


310  Obaervatioiu  on  the  Physiological  and 

that  it  is  so  to  the  consequence  of  their  recent  existence — ^to 
the  exhaustion  they  produce. 

Further,  it  is  remedial,  so  far  as  a  drug  can  be  remedial,  to 
that  exhaustion  which  foUo-ws  unusual  mental  or  physical 
exertion.  It  will  not,  if  taken  prior  to  any  great  effort  being 
made,  prevent  the  resulting  fatigue ;  on  the  contrary,  it  will 
tend  rather  to  increase  it ;  but  the  labour  having  been  under- 
gone alcohol  will,  by  virtue  of  its  Homoeopathic  relationship  to 
excessive  expenditure  of  nervous  force,  remove  it  more  rapidly 
than  rest  and  food  alone  will  do.  A  man  cannot  be  primed 
for  work  by  brandy,  but  he  may  be  freed  in  a  very  great  degree 
from  its  cost  to  himself  by  subsequently  taking  it. 

DISCUSSION. 

Mr.  Cameron,  after  complimenting  the  author  on  the  excel- 
lency of  his  paper,  which  he  considered  one  of  the  best  that  had 
ever  been  presented  to  the  Society  said : — In  studying  the  phy- 
siological and  therapeutical  phenomena  of  alcohol,  two  questions 
prominently  demand  our  attention.  1st.  Is  alcohol  an  aliment  or 
not  ?  In  other  words,  is  it  decomposed  in  the  system,  or  simply 
absorbed  unchanged?  2ndly.  Is  alcohol  a  stimulant  or  an 
anaesthetic  ?  Early  in  this  century,  it  was  proved  by  direct  ex- 
periment, that  alcohol  was  capable  of  causing  intoxication  when 
introduced  into  the  veins  or  serous  sacs  of  an  animal,  but  Brodit3 
and  others  soon  afterwards  ascertained  that,  although  intoxica- 
tion could  be  produced  in  this  way,  the  full  poisonous  eflPects  of 
alcohol — the  shock  to  the  nervous  system  which  causes  death, 
could  only  be  obtained  when  it  was  taken  into  the  stomach. 
Hence,  they  concluded  that  its  full  effects  were  to  be  referred  to 
its  action  on  the  extremities  of  the  nerves  in  its  unaltered  form. 
At  this  time  all  vital  actions  were  explained  on  chemical  prin- 
ciples, and  it  was  therefore  asserted  that  because  spirits  of  wine 
coagulated  albumen,  it  was  impossible  that  alcohol  could  be  ab- 
sorbed into  the  blood  in  its  original  form ;  but  notwithstanding 
these  a  Tpriori  dicta,  Dr.  Ogston  detected  alcohol  by  its  smell  in 
the  ventricles  of  the  brain,  and  Dr.  Percy  soon  afterwards  found 
it,  by  the  same  evidence,  in  the  substance  of  the  brain,  and  made 
the  discovery,  afterwards  so  important,  but  whose  value  was  not 
then  appreciated,  that  a  kind  of  afiinity  existed  between  alcohol 
and  cerebral  matter.  These  gentlemen  relied  on  their  sense  of 
smell  alone  in  their  researches ;  but  other  investigators  followed. 


Therapeutic  Effects  of  Alcohol  311 

who  discovered  pure  alcohol  in  the  fluids  of  animals  by  chemical 
agents.     The  authority,  however,  of  Tiedmann,  Gmelin,  and 
Bouchardat,  and  others,  and  more  lately  that  of  liebig,  who  be- 
lieved that  alcohol  was  decomposed  in  the  system  for  the  purpose 
of  maintaining  animal  heat,  was  arrayed  against  those  who  sup- 
ported the  views  of  Percy  and  Ogston.    Duchek,  one  of  Liebig's 
pupils,  actually  described  the  several  changes  undergone  by  al- 
cohol in  its  stages  towards  combustion,  becoming  Aldehyde, 
then  Acetous  Acid — ^then  Acetic  Acid — then  Oxalic  Acid,  and 
finally  Carbonic  Acid.    This  brought  on  the  famous  controversy 
between  Duchek  and  Masing,  in  which  the  latter  set  aside  the 
validity  of  the  experiments  of  the  former,  and  proved  the  pre- 
sence of  alcohol  in  the  bodies  of  dogs  killed  by  it,  by  the  effects 
of  a  stream  of  air  passed  over  them  into  a  solution  of  Bichromate 
of  Potash  and  Siiphuric  Acid,  which  is  turned  into  an  emerald 
green  by  the  action  of  alcohoL    The  French  chemists  Lalleman, 
Perrin,  and  Duroy  taking  up  these  experiments  of  Masing,  have 
tested  the  smallest  proportions  of  alcohol  in  the  breath,  urine, 
&c.,  &c.,  in  its  unaltered  form.     In  this  way  proofs  of  the  ex- 
halation of  alcohol  have  been  readily  obtained  by  enclosing  the 
arm  of  a  man  who  had  drank  only  one  glassful  of  brandy.     In 
short,  there  can  be  no  doubt,  even  if  we  were  disposed  to  dispute 
the  evidence  of  our  senses  of  smell  and  taste,  that  the  absorp- 
tion of  pure  unchanged  alcohol  into  the  blood  is  clearly  esta- 
blished by  chemical  tests.     This  fact,  then,  answers  in  the 
negative  the  first  question — Is  alcohol  an  aliment,  by  proving 
that  it  passes  out  of  the  system,  imchanged  and  undecomposed. 
Is  alcohol  a  stimulant  or  anaesthetic  ?  A  stimulant  is  a  substance 
which  drives  on  the  actions  of  the  nervous  system  at  an  in- 
creased speed.  Powerful  as  all  the  effects  of  alcohol  are,  it  is  very 
doubtful  whether  it  ever  acts  upon  the  system  in  this  way.     On 
the  contrary,  its  modus  operaridi  seems  to  be  anaesthetic,  as  the 
experiments  of  Dr.  Edward  Smith  prove.    He  found  the  primary 
effects  of  brandy  to  be  "lessened  consciousness  and  lessened 
sensibility  to  light,  sound  and  touch ;  then  stiffness,  with  feel- 
ing of  swelling  of  the  skin,  particularly  of  the  face,  relaxation  of 
the  dartos  and  other  muscles  of  the  reproductive  system,  and  of 
the  sphincter  of  the  bladder,  causing  that  constant  micturition 
which  those  under  the  influence  of  alcohol  exhibit.  The  quantity 
of  carbonic  acid  from  the  lungs,  and  of  urea  and  sulphates  from 
the  urine  is  diminished.     The   apparent  surexcitation  of  the 
mental  faculties  and  energies  which  follow  the  use  of  alcohol 
could  easily  be  shown  to  illustrate  its  anaesthetic  nature.     It  has 
been  proved  that  the  addition  of  a  little  alcohol  to  the  usual  diet 
of  a  man  who  previously  took  none,  increased  the  weight  of  his 


!412  Observations  on  the  Physiological  and 

body  half  a  pound  in  five  days.  The  use  of  a  similar  quantity  of 
alcohol  with  such  a  diminution  of  the  food  as  had  previously  been 
ascoii^ained  to  be  capable  of  reducing  the  weight  at  the  rate  of  a 
(piarter  of  a  pound  daily,  was  found  sufficient,  not  only  to  arrest 
this  diminution,  but  to  add  slightly  to  the  weight  This  is  the 
true  use  of  alcohol.  It  is  an  anaesthetic — it  diminishes  the 
metamor])hosis  of  the  tissues — ^it  arrests  waste.  We  can  thus 
explain  the  beneficial  results  of  alcohol  in  continued  and  other 
low  fevers.  It  docs  good,  not  by  directly  stimulating  and 
i*ousing  the  vitality  and  dormant  actions  of  the  body,  but  by  ar- 
resting waste,  and  thus  conserving  the  powers  of  life  until  such 
time  as  the  patient  can  digest  and  assimilate  proper  nourishment 
1  cannot  conclude  without  directing  the  attention  of  the  society 
to  the  unconscious  testimony  borne  to  the  Homoeopathic  principle 
by  T)t.  Marcet  and  the  other  physicians  who  have  followed  him 
in  prescribing  Oxide  of  Zinc  in  Delirium  Tremens.  This 
medicine  causes  in  the  healthy  subject,  nausea,  giddiness,  black 
specks  before  the  eyes,  rumbling  noises  in  the  head,  faintings, 
tremblings,  &c.  These  are  leading  symptoms  of  Delirium 
Tremens,  and  for  their  cure  this  medicine,  in  very  small  doses,  is 
now  regarded  as  a  specific  by  our  Allopathic  brethren. 

Mr.  F.  H.  Smith  thought  the  paper  a  very  able  and  in- 
teresting one,  the  only  defect  was  that  the  therapeutic  bear- 
ings of  the  subject  were  too  slightly  passed  over.  The  facts 
and  arguments  contained  in  the  paper  confirmed  an  opinion  he 
had  long  entertained,  that  medical  men  were  much  to  blame, 
inasmuch  as  for  the  most  part  they  rather  encouraged  than 
discouraged  the  drinking  habits  of  the  community.  The  writer 
of  the  paper  had  adduced  evidence  that  the  habitual  use  of 
alcohol  lowers  the  vital  powers,  induces  a  carbonized  condition 
of  the  blood,  and  renders  travellers  less  able  to  bear  fatigue  and 
vicissitudes  of  temperature ;  facts  which  his  (Mr.  Smith's)  ob- 
servations and  personal  experience  enabled  him  readily  to  under- 
stand. He  did  not  habitually  use  alcoholic  beverages,  and  when 
occasionally  he  took  a  small  quantity,  the  Gist  effect  he  found 
to  be  stimulating,  the  second  depressing.  He  did  not,  however, 
agi*ee  with  one  of  the  previous  speakers  in  considering  alcohol 
a  direct  sedative.  He  thought  it  bore  an  analogy  rather  to 
opium  than  to  hydrocyanic  acid  in  its  symptoms.  The  primary 
effect  of  a  small  dose  of  opium — say  a  quarter  of  a  grain — ^was 
evidently  stimulating ;  but  when  two  or  three  grains  were  taken 
the  secondary  or  sedative  effect  was  induced  so  rapidly  that  the 
primary  or  stimulating  effect  was  scarcely  observable — ^thus 
bearing  a  close  analogy  to  the  .symptoms  produced  by  a  large 
dose  of  alcohol.    He  believed  from  many  years'  observation  that 


Therapeutic  Effects  of  A  Icohd,  813 

the  habitual  use  of  alcoholic  drinks  was  geneially  unnecessary, 
and  that  a  proclivity  was  thereby  induced  to  various  forms  of 
disease. 

Dr.  Drury  felt  much  indebted  to  Mr.  Pope  for  the  interesting 
and  instractive  paper  that  had  just  been  read.  The  difficulty  of 
deciding  on  the  primary  action  of  alcohol  was  very  great ;  his 
own  opinion  was  that  the  quantity  taken  decided  the  point ; 
a  small  quantity  stimulating,  a  Is^ei  quantity,  at  first  de- 
pressing, afterwards  exciting;  a  very  large  or  poisonous  dose 
causing  very  great  depression.  It  was  a  valuable  remedy,  as  it 
checked  waste  of  the  tissues,  increased  the  animal  heat,  and  in 
cases  of  exhaustion  or  syncope,  roused  vitality  by  its  stimulating 
action.  The  quantity  borne  depended  on  the  state  of  the 
patient  Thus,  in  a  case  of  uterine  hoemorrhage,  he  had  given 
a  pint  of  brandy  in  the  space  of  about  two  hours,  te  a  lady  who 
at  other  times  could  not  teuch  it.  Humanly  speaking,  there 
was  no  doubt  she  owed  her  life  to  this  remedy.  In  fatty  disease 
of  the  heart  small  quantities  of  spirits  with  water  suited  better 
than  other  stimulants.  In  some  forms  of  dyspepsia  a  little 
weak  brandy  and  water  could  often  be  taken  when  ale  or  wine 
disagreed.  Though  advocating  the  moderate  use  of  stimulants, 
it  would  be  wrong  to  avoid  expressing  a  very  strong  condemna- 
tion of  the  enormous  quantity  of  ale  or  beer  some  men  took ; 
it  was  wasteful  and  hurtfuL  One  could  not  fail  being  astonished 
at  the  great  quantity  some  workmen  took ;  even  gentlemen  who 
dined  in  the  City,  as  a  rule,  felt  it  necessary  to  ask  for  a  pint, 
though  often  half  that  quantity  might  be  quite  sufficient ;  the 
accustoming  the  stomach  to  take  more  than  it  required  could  not 
but  be  injurious.  Moderation  was  good  in  all  things,  but  in 
few  more  so  than  in  this.  Mr.  Smith  points  out  the  difference 
between  the  primary  and  secondary  action  of  opium,  which  Mr. 
Cameron  has  rather  overlooked.  In  giving  alcohol  in  illness 
it  was  of  consequence  to  know  when  to  give  it  Thus  in  the 
deliriimi  of  fever,  when  some  might  dread  excitement,  Dr. 
Stokes,  of  Dublin,  chose  that  very  sjmptom  as  his  indication 
for  giving  stimulants.  Where  such  a  rule  as  this,  founded  on 
experience,  is  laid  down,  it  is  a  very  valuable  help.  Though 
the  amount  given  must  stUl  be  regulated  by  the  experience 
of  the  practitioner,  and  the  effect  in  each  case. 

Dr.  EusSELL  said, — He  entirely  concurred  in  the  high  terms 
of  appreciation  used  by  Mr.  Cfimeron,  whose  knowledge  of  the 
subject  made  his  opinion  of  great  value,  in  reference  to  the  learn- 
ing and  talent  displayed  by  Mr.  Pope  in  the  essay  they  had  just 
h^uxL  At  the  same  time,  he  was  not  altogether  convinced  that 
the  views  expressed  by  Mr.  Pope  and  endorsed  by  Mr.  Cameron, 


314  Observations  on  the  Physiological  and 

were  quite  correct.     It  seemed  to  him  (Dr.  Eussell)  that  the 
question  should  be  looked  at  from  two  distinct  points  of  view, 
first,  as  one  of  diet,  and  then  as  one  of  therapeutics.     In  regard 
to  the  former,  he  would  prefer  deriving  general  conclusions  from 
the  immense  field  of  observation  which  lay  open  to  them  in 
history,  rather  than  from  the  deductions  of  modem  chemists. 
The  use  of  alcohol  in  some  form  or  other,  was  coeval  with  the 
earliest  records  of  the  human  race.    It  seemed  to  him  somewhat 
parodoxical  to  maintain  that  an  article  of  diet  on  which  mankind 
had  thriven  for  many  thousand  years,  was  a  poison.     Surely  such 
a  term  was  misapplied !  surely  there  must  be  some  fallacy  in  the 
chemist's  view  of  the  question !    He  conceived  that  there  was 
this  fallacy.    The  chemist  dealt  with  dead  matter,  not  with 
living ;  man  to  the  eye  of  the  chemist  was  a  compound  of  oxy- 
gen, nitrogen,  carbon,  phosphorus,  sulphur,  &c. ;  but  man  to  the  eye 
of  a  common  observer  was  something  far  different ;  he  was  living 
spirit  incorporated  into  a  living  body,  each  acting  and  re-acting 
on  the  other.     Now  it  may  be  true  that  the  wine  we  drink  does 
not,  as  the  chemists  tell  us,  form  any  portion  of  any  tissue  of  our 
bodies  ;  nevertheless,  it  may  materially  affect  the  formation  of  all 
the  tissues  by  exhilarating  what  in  old  phraseology  were  called 
the  animal  spirits,  and  inducing  what  might  be  called  a  happier 
nutrition.    How  different  is  a  meal  eaten  in  silence  and  sadness, 
to  the  same  meal  enjoyed  in  pleasant  society.     The  judicious  and 
moderate  use  of  stimulants  may  propitiate  the  digestive  powers 
by  stimulating  them  to  the  proper  pitch,  and  may  thus,  although 
not  themselves  nutriments,  enable  more  nutrition  to  take  place. 
At  all  events,  this  is  a  question  which  must  be  decided  by  ob- 
serving the  effects  of  such  substances  on  living  men,  and  can 
never  be  settled  by  distilling  dead  dogs.     In  regard  to  the  use  of 
wine,  beer,  and  spirits  medicinally,  there  is  perhaps  no  greater 
test  of  the  practical  tact  of  a  physician,  than  his  management  of 
these  confessedly  dangerous  weapons.    We  have  all  seen  and 
heard  of  many  illustrations  of  the  danger  of  medical  practitioners 
being  led  away  by  a  crotchet,  and  either  insisting  upon  total 
abstinence  even  from  food,  much  more  from  stimulants,  and  on 
the  other  hand,  of  others  following  the  opposite  plan,  and  stimu- 
lating immensely  in  all  cases.      Both  extremes  are  equally 
dangerous.     The  surest  indications  for  the  use  of  stimulants  were 
derived  from  the  state  of  the  pulse.    The  pulse  was  not  made 
the  subject  of  such  refined  study  as  it  used  to  be ;  it  required  a 
highly  educated  finger  to  read  the  pulse  aright.    We  owe  much 
to  Drs.  Stokes  and  Graves,  for  their  valuable  instructions  in 
regard  to  the  use  of  wine  in  fever,  as  well  as  to  Dr.  Alison  and 
others.    What  they  insist  on  is,  that  we  should  ascertain  the 


Therapeutic  Ejffects  of  Alcohol.  315 

condition  of  the  heart.  It  was  stiggested  by  Mr.  BL  Smith  that 
the  use  of  alcoholic  liquors  induced  fatty  heart.  This  may  be  so 
in  some  instances,  in  others,  however,  the  judicious  use  of  stimu- 
lants seems  to  arrest  the  progress  of  this  disease,  when  it  arises 
firom  insufficient  innervation.  Besides  being  guided  by  the  state 
of  the  pulse,  we  must  narrowly  observe  the  condition  of  the 
brain.  We  are  apt  to  be  deceived  in  the  symptoms  of  this  organ, 
and  to  set  down  to  a  state  of  over-action  phenomena  due  to  a 
condition  of  want  of  nutrition.  The  delirium  of  a  person  in  a 
state  of  starvation  resembles  that  of  one  intoxicated.  In  the 
management  of  incipient  puerperal  mania,  which  used  to  be  con- 
sidered as  an  inflammatory  condition  requiring  depletion  and 
abstinence,  the  modem  practice  enjoined  by  Dr.  Simpson  is  free 
stimulation  and  feeding, — ^and  so  it  is  in  many  other  affections. 

Mr.  Teldham  said, — ^Few  subjects  associated  with  medicine 
were  of  more  importance  than  that  which  Mr.  Pope  had  brought 
under  the  notice  of  the  Society  in  his  interesting  and  able  paper. 
In  spite,  however,  of  Mr.  Pope's  arguments,  he  preferred  Leibig's 
explanation  of  the  action  of  alcohol  to  emy  other  he  had  met 
with.  That  explanation  was,  to  his  mind,  thoroughly  consistent 
with  all  the  known  phenomena  of  alcohol,  both  in  health  and 
disease.  It  was,  in  brief,  a  decoyer  of  oxygen  into  the  system. 
The  affinity  between  oxygen  on  the  one  hand,  and  carbon  and 
hydrogen  on  the  other,  was  the  great  motive  power  in  respira- 
tion ;  and  in  alcohol  we  had  a  hydro-carbon  in  the  fittest  con- 
dition for  instantaneous  absorption  into  the  circulation.  This 
rapid  absorption  explained  some  phenomena  of  its  action,  which 
else  were  unaccountable.  For,  observe,  whilst  other  carbonaceous 
substances — ^fat,  oU,  &c.,  had  a  tissue — ^the  adipose— devoted  to 
their  reception,  where,  as  in  a  store-house,  they  were  deposited 
untU  required  for  combustion,  alcohol  had  no  such  depository, 
but  was  carried  directly  into  the  circulation.  What  followed  ? 
This, — ^when  it  was  taken  rapidly,  and  in  a  large  quantity,  it 
produced  the  phenomena  of  drunkenness.  It  was  poured  into 
the  system  faster  than  the  lungs  could  bum  it ;  part  of  it  was 
consumed ;  part  passed  off  in  the  breath  unconsumed,  imparting 
to  it  its  own  odour;  whilst  another  part,  circulating  in  the 
blood  unchanged,  induced  on  the  biain  the  symptoms  of  poisoning 
by  carbon.  Now,  change  the  conditions;  let  a  man  imbibe 
alcohol  in  equal  quantity,  but  gradually ,  and  he  would  sit  over 
his  bottle  for  hours  and  hours,  without  exhibiting  any  of  the 
foregoing  symptoms,  for  the  simple  reason  that  he  took  no  more 
alcohol,  and  no  faster,  than  his  system  could  consume  as  it  was 
taken.  The  two-bottle  man  was  not,  after  all,  so  great  a  wonder 
as  was  sometimes  supposed ;  he  did  not  walk  away  with  all  that 
wine  under  his  skin ;  he,  in  fact,  carried  away  but  very  little — 


316  Observations  on  the  Physiological  and 

he  had  consumed  it  as  he  drank  it.    Again,  cold  and  pure  air, 
which  contains  a  large  quantity  of  oxygen,  carried  off,  so  to 
speak,  the  effects  of  alcohol  on  the  system.    Hence,  coachmen, 
and  cabdrivers,  and  sailors  could  take  with  impunity  quantities 
of  alcohol,  which  could  not  be  borne  by  persons  confined  in  close 
rooms.     Apply  these  considerations  to  the  treatment  of  ex- 
hausting disease — hoemorrhage,  and  fevers — and  the  same  prin- 
ciples held  good.     In  both  these  cases  they  had  loss  of  power — 
in  the  one  from  the  loss  of  vital  fluid,  in  the  other  from  the  ces- 
sation of  nutrition ;  and,  in  both,  beyond  the  use  of  medicines, 
the  principles  of  cure  were  embraced  in  fresh  air,  nutrition,  and 
alcohol — i.  e,,  carbon  internally  in  the  most  convertable  form  ; 
oxygen  externally  to  combine  with  it ;  and  light  food  to  sustain 
the  vital  powers  whilst  disease  ran  its  course,  and  imtil  more 
suitable  food  could  be  taken  and  digested.     One  word  as  to  the 
period  of  the  day  when  alcohol  could  be  taken  with  greatest  ad- 
vantage.    Clearly,  as  a  rule,  it  should  not  be  taken  in  the  fore 
part  of  the  day.     The  system  was  then  in  the  enjoyment  of  the 
nerve-power  generated  during  rest  and  sleep,  and  did  not  reqtdre 
the  stimulation  of  alcohoL     It  was  then  mere  surplusage,  which 
embarrassed  the  system.    But,  later  in  the  day,  after  the    wear 
and  tear  of  the  working  hours,  substantial  food  was  demanded, 
and  alcohol  would  often  be  indulged  in  with  imj)unity  and  ad- 
vantage.    Unless  in  exceptional  cases,  he,  Mr.  Yeldham,  was 
satisfied,  from  reasoning  and  observation,  that  the  custom  which 
now  prevailed  with  many  medical  men  of  ordering  alcoholic 
drinks  for  all  hours  of  the  day — for  breakfast  and  luncheon  as 
well  as  dinner — ^was  xmscientific  and  prejudicial     It  was  rarely 
that  alcohol,  even  in  healthy  persons,  could  be  borne  with  comfort 
on  an  empty  stomach,  or  before  dinner.     These  remarks,  of 
course,  did  not  apply  to  fevers  and  other  exhausting  diseases,  in 
which  the  administration  of  alcohol  must  be  determined,  both 
as  to  time  and  quantity,  by  the  condition  of  the  patient.     But, 
even  here,  its  good  effects  were  best  displayed  when  it  was  given 
in  small  quantities,  rather  frequently  repeated,  and  mixed  with 
light  food :  beef  tea,  chicken  broth,  arrowroot,  and  the  lika     In 
conclusion,  Mr.  Yeldham  thanked  Mr.  Pope  for  his  excellent 
paper,  and  for  the  trouble  he  had  taken  in  travelling  from  York 
to  read  it      Such  acts  of  co-operation  from  their  provincial 
brethren  were  particularly  grateful  to,  and  were  much  valued  by, 
the  metropolitan  members  of  the  Society. 

Mr.  Pope  said : — I  do  not  purpose,  gentlemen,  occuping  your 
time  with  any  lengthened  remarks  on  the  discussion  which  has 
taken  place,  but  I  must  tender  you  my  thanks  for  the  flattering 
manner  in  which  you  have  received  the  paper  I  have  had  the 
honour  of  reading.    Mr.  Cameron  remarked  that  Alcohol  was 


Therapeutic  Effects  of  Alcohol.  317 

not  a  real  Btiinulant,  but  a  depressor  of  vital  action.  This  I  hold 
to  be  true  of  its  action  in  health.  In  the  healthy  man^  as  I 
have  endeavoured  to  show,  it  produces  general  depression,  and 
especially  is  this  result  observed  in  the  nervous  system.  But  on 
the  other  hand,  by  virtue  of  this  action,  emd  in  strict  harmony 
with  the  homoeopathic  law,  it  specifically  removes  nervous  depres- 
sion when  existing  as  a  morbid  product  Because,  then,  in- 
creased vitality  follows  its  specific  action,  it  may  be  regarded  as 
a  stimulant,  while  in  health  it  is  far  from  being  so.  Again,  it  is 
an  arrester  of  metamorphosis  only  when  in  disease  metamor- 
phosis is  proceeding  too  rapidly,  is  in  reality  waste  of  tissua  It 
here  restores  normal  metamorphosis  by  checking  that  which  is 
abnormal  and  excessive,  the  very  condition  to  which  it  gives  rise 
in  health.  Mr.  Harmar  Smith  aUuded  to  the  responsibility  en- 
tailed in  prescribing  Alcohol  in  disease.  My  impression  is,  that 
our  responsibility  as  practitioners  of  Medicine  consists  in  our 
ordering  such  medicines,  and  such  medicines  only,  as  are  needful 
for  restoration  to  health ;  whatever  is  needed  for  this  purpose 
must  be  given,  without  any  regard  to  the  future  self-control  of 
our  patients.  If  alcohol  is  needed  for  the  promotion  of  their 
recovery  we  ai*e  bound  to  prescribe  it,  whether  when  beyond  our 
control  they  will  continue  to  indulge  in  a  palatable  but  dan- 
gerous drug,  though  highly  valuable  remedy,  or  whether  they 
will  refrain  from  it.  That  is  no  business  of  ours.  With  refer- 
ence to  the  case  mentioned  by  Dr.  Drury,  I  would  observe,  that 
in  Dr.  Smith's  experiments  the  heart's  action  was  found  to  be 
increased  during  the  first  thirty  or  forty  minutes  after  alcohol 
had  been  taken,  and  it  may  be,  that  by  the  frequent  and  free 
repetition  of  brandy,  this  increased  action  may  be  kept  up  for 
some  considerable  time.  Dr.  Eussell  argued  that  custom  not 
only  sanctions  the  use  of  alcohol,  but  proves  that  it  is  advan- 
tageous as  an  article  of  diet.  That  because  people  have  in  aU 
generations  taken  more  or  less  alcohol,  they  must  have  thriven 
upon  it.  I  confess  I  cannot  see  the  force  of  the  inferenca  As 
well  might  it  be  said  that  arsenic  is  a  food,  is  productive  of 
superior  vitality,  because  the  Styrian  peasantry  have  long  accus- 
tomed themselves  to  eating  it.  Doubtless  habit  enables  a  man 
to  do  with  less  harm  to  himself  that  which,  but  for  the  habit, 
would  be  highly  injurious  to  him.  But  it  by  no  means  follows 
that  the  habit  of  taking  a  drug  at  regular  intervals,  which,  used 
only  occasionally,  would  be  productive  of  disease,  is  a  desirable 
or  health  promoting  habit,  neither  can  we  conclude  that  it  is  an 
entirely  innocuous  one.  A  substance  may  be,  and  is,  a  poison, 
without  tinder  all  circumstances  inducing  its  poisonous  effects. 
Instead  of  arguing  that  alcoholic  fluids  have  been  constantly 
taken  because  of  their  health  inspiring  properties,  it  a^^^^^s^  \i^ 


318  Case  of  Oangrena  Senilis, 

me  that  the  secret  of  their  general  use  is  to  be  found  in  their 
palatable  nature.  Good  old  port,  sound  beer,  brandy  punch,  &c., 
are  all  agreeable  to  the  taste,  and  therefore  are  freely  indulged 
in.  When  heavy  labour,  physical  or  intellectual,  has  been  under- 
gone for  some  time,  and  the  strength  to  continue  it  as  long  as 
may  be  required  is  failing,  a  dose  of  brandy  may,  by  its  homoeo- 
pathic relationship  to  the  induced  waste,  check  it,  and  so  allow 
of  the  completion  of  the  work.  This  power  is  alluded  to 
by  one  of  the  Arctic  travellers  [Mr.  Cameron — ^Dr.  Hooker.] 
But  on  the  other  hand,  it  cannot  produce  power  anticipatory  of 
waste.  Mr.  Yeldham  remarked  that  alcohol  was  not  specially 
deposited  in  any  organ.  It  is  not  so  in  a  decomposed  state 
certainly,  but  in  its  integrity  it  finds  a  nidus  in  the  brain  to  a 
very  considerable  extent.  It  is,  it  is  true  exhaled,  but  not  as  so 
much  carbon  and  hydrogen ;  it  passes  off  from  the  lungs  as  it 
entered  the  stomach,  as  alcohol.  The  impunity  with  which 
more  or  less  alcohol  is  taken  is  in  proportion  to  the  individual 
power  of  evolving  it  The  workers  in  the  Staffordshire  iron 
founderies,  who  are  constantly  in  a  state  of  profuse  perspiration, 
measure  their  allowance  of  beer  by  the  gallon,  not  the  pint.  In 
conclusion,  I  may  remark  that  while  much  difference  of  opinion 
evidently  prevails  as  to  the  modus  operaridi  of  alcohol,  we  all 
seem  to  agree  as  to  the  class  of  cases  in  which  it  is  needed,  viz., 
those  in  which  danger  arises  from  nervous  prostration.  This 
state  I  believe  alcohol  produces  in  health  ;  to  it  therefore  it  is 
Homoeopathic  when  arising  in  the  ordinary  course  of  diseasa  I 
again  thank  you  for  the  reception  you  have  have  accorded  to  my 
paper,  and  at  the  same  time  take  this  opportunity  of  expressing 
the  pleasure  I  have  felt  in  being  present  here  this  evening. 


CASE  OF  GAITGEENA  SENILIS. 

The  last  illness  of  Archbishop  Whateley. 

The  public  and  unconpromising  testimony  borne  by  my  late 
much  lamented  patient  to  the  truth  of  our  medical  creed,  ren- 
ders it  imnecessary  to  apologise  for  bringing  before  the  Society 
a  short  notice  of  the  last  illness  of  Archbishop  Whateley.  One 
of  his  Grace's  most  remarkable  characteristics  was  an  honest  love 
of  truth.  This  in  a  mind  of  unbounded  capacity,  gave  rise  to  a 
strong  impulse  to  investigate  every  new  discovery  that  came 


Case  of  Oangrena  Senilis.  319 

before  him  fairly  supported.  Having  rigidly  tested  it,  and 
being  once  convinced  that  a  subject  was  based  upon  truth,  he 
became  its  firm  and  unflinching  advocate.  He  told  me  that 
his  final  decision  in  favour  of  Homoeopathy  was  due  to  the 
case  of  a  favourite  dog,  which  had  been  unsuccessfully  treated 
for  many  months  by  veterinary  surgeons,  and  was  cured  by  Dr. 
Karl  Sutton  in  a  fortnight. 

The  following  memorandum  was  written  about  fourteen 
years  ago,  and  speaks  for  itself.  It  is  copied  verbatim  from 
the  original  in  his  Grace's  hand  writing,  but  unfortunately 
bears  no  date. — "  Memorandum  : — 

"  In  case  of  my  being  seized  with  any  disorder  that  de- 
"  prives  me  of  speech  or  reason,  my  earnest  desire  is,  that  none 
"  of  the  ordinary,  as  they  are  called.  Allopathic  practitioners, 
"  may  be  called  in ;  but  that  Homoeopathy  may  be  resorted  to, 
"  if  any  one  can  be  found  to  prescribe,  and  if  not,  I  may  be 
"  left  to  nature.  And  in  case  of  my  death,  this  memorandum 
"  may  be  produced  as  a  vindication  of  my  attendants." 

The  following  correspondence  between  a  celebrated  Allo- 
pathic physician  and  his  Grace,  although^  perhaps,  known  to 
the  members  of  this  Society,  is  of  sufficient  interest  to  deserve 
being  recorded  hera 

''London,  13th  June,  1862. 

"  My  Lord  Archbishop, 

"  We  are  informed  that  the  Eoyal  College  of  Surgeons  in 
Ireland  ordained  last  August  that  *  no  fellow  or  licentiate  of 

*  the  Eoyal  College  shall  pretend  or  profess  to  cure  diseases 

*  by  the  deception  called  Homoeopathy  or  the  practice  called 

*  Mesmerism,  or  by  any  other  form  of  quackery.'  *  It  is  also 
hereby  ordained  that  no  fellow  or  licentiate  of  the  College  shall 
consult  with,  meet,  advise,  direct  or  assist  any  person  engaged 
in  such  deceptions  or  practices,  or  in  any  system  or  practice 
considered  derogatory  or  dishonorable  by  physicians  or  sur- 
geons.*    Is  your  Grace  aware  of  this  ? 

"  I  have  the  honor  to  remain, 

"  Tour  very  faithful  servant, 


320  Case  of  Oangrena  Senilis, 

"  My  Dear  Sir, 

"  I  was  well  aware  of  the  detestable  act  of  tyranny  you 
refer  to.  I  believe  some  persons  were  overawed  into  taking 
part  in  it  against  their  own  judgment.  I  have  always  pro- 
tested against  such  conduct  in  all  departments  of  life.  You 
may  see  something  to  the  purpose  in  my  little  penny  tract  on 
'Trades  Unions'  (to  be  had  at  Parker's).  In  fact,  the  present 
is  one  of  the  Trades  Unions.  A  man  has  a  right  to  refuse  to 
work,  except  for  such  wages  or  under  such  conditions  as  he 
himself  choose  to  prescribe,  but  he  has  no  right  to  compel 
others  to  concur  with  him.  If  there  is  any  mode  of  medical 
treatment  which  he  disapproves  of,  or  any  system  of  education 
which  he  thinks  objectionable,  he  will  be  likely  to  keep  clear 
of  it  of  his  own  accord,  without  any  need  of  compulsion  or 
pledges.  Those,  again,  who  may  think  differently,  ought  not 
to  be  coerced  or  bullied.  Some  persons  seem  to  have  a  notion 
that  there  is  some  connection  between  persecution  and  religion, 
but  the  truth  is,  it  belongs  tg  human  nature.  In  all  depart- 
ments of  life  you  may  meet  with  narrow-minded  bigotry,  and 
uncharitable  party  spirit.  Long  before  the  outbreak  of  the 
Eeformation  the  Nominalists  and  the  Eealists  of  the  logical 
school  persecuted  each  other  unmercifully — so  have  Eoyalists 
and  Eepublicans  done  in  many  other  countries ;  and  in  our 
own  country  the  Trades  Unions  persecute  any  one  who  does 
not  submit  to  their  regulations.  In  Ireland,  if  any  one  takes 
a  farm  in  contravention  to  the  rules  of  the  agrarian  conspi- 
rators, he  is  waylaid  and  murdered ;  and  if  he  embraces  the 
Protestant  faith,  his  neighbours  aU  conspire  to  have  no  dealings 
with  him.  The  truth  is,  the  majority  of  mankind  have  no 
real  love  of  liberty,  except  that  they  are  glad  to  have  it  them- 
selves, and  to  keep  it  all  to  themselves,  but  they  have  neither 
spirit  enough  to  stand  up  firmly  for  their  own  rights,  nor  suf- 
ficient sense  of  justice  to  respect  the  rights  of  others.  They 
will  submit  to  the  domineering  of  a  majority  of  their  own 
party,  and  will  join  with  them  in  domineering  over  others. 
In  the  midst  of  the  disgust  and  shame  which  one  must  feel 
at  such  proceedings  as  you  have  alluded  to,  it  is  some  conso- 
lation to  the  advocates  of  the  systems  denounced,  to  see  that 
there  is  something  of  a  testimony  borne  to  them  by  their  ad- 


Case  of  Oangrena  Senilis,  321 

versaries,  who  dare  not  trust  the  cause  to  the  decision  of  reason 
and  experience,  but  resort  to  such  expedients  as  might  as  ably 
be  employed  for  a  bad  cause  as  a  good  one. 

Signed,         "R  Dublin;' 

In  connexion  with  the  above,  I  may  submit  to  the  Society 
the  following  correspondence : — 

"The  Palace^  2Uh  Feb,,  1862, 
"Deae  Db.  Scriven, 

"  The  Archbishop's  male  friends  are  all  very  anxious  that 
he  should  allow  either  Dr.  A — ,  Dr.  B — ,  or  Dr.  H —  to  see 
his  leg.  He  thinks  it  rather  worse,  but  I  should  hope  that  is 
only  fancy.  However,  he  wishes  to  satisfy  his  friends,  and 
Miss  Whately  told  him  that  you  had  not  the  least  objection  to 
his  seeing  a  surgeon,  and  he  has  therefore  asked  me  to  beg 
you  to  fix  upon  which  ever  you  like  of  these  three,  and  appoint 
an  hour  to-morrow  to  meet  him  here.  The  Archbishop  begs 
me  to  add,  that  he  has  not  the  least  fault  to  find  with  your 
treatment  of  the  case.  Miss  Whately  is  dining  out  to-day, 
which  is  the  reason  that  I  am  writing.  The  Archbishop  told 
me  that  I  might  write  in  his  name  in  the  third  person,  but  I 
thought  that  I  could  better  explain  myself  in  the  first. 

"  Believe  me, 

**  Tours  most  sincerely, 
«A.  S." 

To  this  I  replied  that  I  should  be  most  happy  that  a  surgeon 
should  see  his  Grace,  and  named  Dr.  A — ,  but  added,  that  I 
feared  no  Dublin  surgeon  would  meet  me  in  consultation. 

"  The  Palace,  Monday  Night 
"Dbae  Db.  Scriven, 

"  Many  thanks  for  your  kind  note,  but  his  Grace  cannot 
call  in  a  surgeon.  Ycm  must  do  it,  or  it  cannot  be  done  at  all. 
He  can  have  no  one  who  will  not  meet  you.  If  Mr.  A.  will 
do  so,  very  well ;  and  his  Grace  begs  me  to  say  that  you  can 
name  any  hour  to-morrow  for  your  meeting  here,  only  let  him 
know  beforehand.       As  I  said  before,  his  Grace  is  perfectly 

21 


322  Ca$e  of  Oangrena  Senilis.   - 

satisfied  with  your  treatment,  but  to  please  some  of  his  friends 
he  will  see  a  surgeon  with  you — not  otherwise. 

"  Very  sincerely  yours, 

"A.  S." 

On  receipt  of  the  foregoing,  I  wrote  to  Dr.  A.  as  follows : — 

"Dr.  Scriven  presents  his  compliments  to  Dr.  A.,  and 
begs  to  say  that  he  is  in  attendance  on  the  Archbishop  of 
Dublin,  who  is  suffering  from  a  small  ulcer  on  the  outer  ankle. 
His  Grace  having  been  urged  by  some  of  his  friends  to  obtain 
the  opinion  of  an  eminent  surgeon,  Dr.  Scriven  has  named 
Dr.  A.,  and  would  be  glad  to  know  at  what  hour  to-morrow  it 
would  be  his  convenience  to  call  on  his  Grace.  Enclosed  is 
a  note  which  Dr.  Scriven  has  just  received  from  a  relative  of 
the  Archbishop's,  at  present  at  the  Palace,  by  which  Dr.  A  will 
perceive  that  his  Grace  wishes  to  continue  Homoeopathic  treat- 
ment, so  far  as  his  general  health  may  require  it. 

"  2^th  Feb,  1862.  "  Monday  NigUr 

25th  Feb.,  1862. 
"Mr.  A.  presents  his  compliments  to  Dr.  Scriven,  and 
reply  to  his  note  just  received,  begs  to  say,  that  as  his  Grace 
the  Archbishop  of  Dublin  has  decided  that  he  will  have  no 
surgeon  to  visit  him  who  will  not  meet  Dr.  Scriven  in  consul- 
tation, Mr.  A.  regrets  that  he  cannot  have  the  honour  of  pre- 
scribing for  his  Grace  under  circumstances  which  would  be  a 
direct  violation  of  a  recent  "ordinance"  of  the  College  of 
Surgeons  in  Ireland,  of  which  Dr.  Scriven  is  aware." 

"  Palace,  Tuesday  Morning. 
"  Deab  Db.  Scriven, 

"  His  Grace  is  so  opposed  to  tyranny  in  any  shape,  that 
things  must  go  on  as  they  are,  and  I  have  no  doubt  that  it  is 
all  for  the  best. 

"  Yours  sincerely, 

"A.  S." 

He  was  one  of  the  Vice-Presidents  of  the  London  Homoeo- 
pathic Hospital,  and  a  liberal  contributor  to  its  fimds,  as  well 
as  to  those  of  the  Dublin  Dispensary.  His  knowledge  of  botany 
and  natural  history  was  most  extensive  ;  he  was  also  largely 


Case  of  Gangrena  Senilis.  323 

acquainted  with  the  uses  of  herbs  as  domestic  remedies  in 
different  countries.  This  is  not  the  place  to  recount  his  Grace's 
literary  labours,  which  are  in  the  possession  of  the  public. 
Without  further  preface,  I  shall  proceed  to  give  a  brief  history 
of  the  illness  which  removed  from  his  sphere  of  usefulness  this 
truly  great  and  good  man  at  the  age  of  76. 

On  the  2nd  July  1863,  his  Grace  the  late  Archbishop  of 
Dublin,  sought  my  advice  for  a  small  blackish-looking  spot, 
about  the  size  of  a  fourpenny  piece,  on  the  tendo  achillis,  two 
inches  above  the  os  calcis,  and  more  than  half  an  inch  above  where 
the  upper  edge  of  the  shoe  pressed.  It  had  existed  for  a  fort- 
night before  I  saw  it,  and  had  been  poulticed  with  white  lily 
root.  There  was  no  appearance  Of  redness  or  inflammation 
around  it,  nor  was  there  any  oedema  of  the  foot  at  this  time. 
No  mechanical  injury  of  any  kind  had  occurred  to  which  it  could 
be  attributed ;  the  pain  was  described  as  of  a  burning  kind, 
and  at  times  stabbing  "  as  if  a  red-hot  gimlet  were  run  into  it.** 
It  may  be  well  to  state  here,  that  his  Grace  had  suffered  during 
the  previous  seven  years  from  a  paralytic  affection,  principally 
of  the  left  side,  by  which  the  left  leg  was  much  enfeebled. 
There  was  also  paralysis  agitans  of  both  hands.  This  infirmity 
had  come  on  gradually  without  any  apparent  cause,  and  slowly 
and  steadily  increased,  interfering  very  much  with  the  power  of 
locomotion,  and  preventing  his  taking  the  amount  of  exercise 
requisite  for  health,  and  to  which  he  had  always  been  accus- 
tomed. Against  this  his  Grace  struggled  manfully,  and  persisted 
in  taking  a  daily  walk  before  breakfast  and  lunch.  Of  late 
his  appetite  had  not  been  good,  but  he  partook  of  animal  food 
three  times  a  day,  and  took  a  rather  large  amount  of  wine  and 
other  stimulants,  including  brandy,  strong  coffee,  and  snuff.  In 
the  winter  of  1861,  I  had  treated  a  small  but  most  painfully 
irritable  idcer  situated  below  the  outer  ankle  of  the  other  or 
left  foot.  It  yielded  to  homoeopathic  treatment,  combined  with 
the  use  of  the  Turkish  bath,  which  his  Grace  found  most  in- 
vigorating and  agreeable,  and  which  he  continued  to  t^V^  ^iXiWiis. 

2\* 


324  Com  of  Oangrena  Senilis. 

once  every  week  or  ten  days,  until  confined  to  his  country 
residence  by  the  attack  now  under  consideration. 

For  the  symptoms  above  detailed,  Arsenicum  6  was  the 
medicine  first  prescribed,  and  cold  water  dressing  to  the  sore, 
with  hot  fomentations  night  and  morning.  Arsenicum  was 
continued  for  a  week  without  any  alleviation,  and  Arnica  3  was 
given  with  Arnica  lotion  locally.  No  improvement  resulted, 
and  Secale  Cor.  3  was  ordered,  with  a  similar  result.  The 
brownish  dry  patch  spread  very  gradually,  creeping  downwards 
and  forwards  in  the  direction  of  the  outer  ankle.  The  foot 
became  cedomatous,  and  some  swelling  appeared  in  the  leg. 
Lachesis  was  next  given,  and  a  poultice  of  linseed  meal  and 
barm  applied  thrice  a  day,  the  foot  and  leg  being  bathed  in  hot 
water,  when  the  poultice  was  removed,  and  well  rubbed  and  mes- 
merised night  and  morning.  The  mesmerism  appeared  to  have 
a  temporary  effect  in  soothing  pain.  By  the  first  week  in 
August  the  sore  had  extended  in  the  direction  of  the  external 
malleolus,  and  formed  a  junction  with  a  similar  brown  patch 
which  made  its  appearance  on  the  cicatrix  of  an  old  ulcer  long 
since  healed,  directly  under  the  ankle.  The  deeper  structures 
were  beginning  to  suffer  from  the  destructive  process,  and  the 
surface  of  the  tendo  achillis  became  exposed,  assuming  a  dirty 
brownish  appearance ;  there  was  little  or  no  discharge.  There 
being  considerable  foetor  which  distressed  the  patient,  a  layer  of 
very  finely  powdered  peat  charcoal  was  spread  on  the  poultice, 
and  Carb.  Veg.  was  given  internally.  No  benefit  resulting 
from  this  change,  the  poultice  was  discontinued,  and  several 
folds  of  lint  moistened  with  Hydrastis  lotion  and  covered  with 
oiled  silk  was  applied,  while  Hydrastis  3  was  given  internally. 
The  oedema  and  pain  increasing;  this  was  after  some  days 
abandoned,  the  poultice  resumed,  and  as  there  was  much  redness 
and  swelling.  Belladonna  was  given.  The  redness  subsided,  but 
the  swelling  continued,  and  the  destructive  process  extended 
up  the  leg  to  the  extent  of  four  or  five  inches  above  the  os 
calcis  and  below  the  outer  ankle,  while  it  implicated  the  whole 


Case  of  Oangrena  Senilis,  325 

structure  of  the  tendon,  whicli  became  a  soft  pulpy  mass  of 
brown  disorganised  fibres,  the  foetor  of  which  was  most  offen* 
sive.  Various  medicines  having  been  given  in  addition  to 
those  mentioned,  viz.,  Mercurius,  Plumbum,  Causticum,  and 
China.  At  the  suggestioa  of  Dr.  Blythe,  who  saw  his  Grace 
frequently  in  consultation,  it  was  decided  to  give  the  first  dilu- 
tion of  China,  and  the  first  trituration  of  Ammon.  Carb.  in 
alternation,  and  to  apply  a  resinous  ointment  to  the  sore. 
After  some  days,  no  improvement  resulting,  the  simple  poultice 
was  resumed,  and  to  relieve  the  distressing  odour,  pieces  of  lint 
wet  with  a  solution  of  Permanganate  of  Potash,  were  placed 
outside  the  other  dressings.  Some  slight  diarrhoea  that  had  set 
in  was  immediately  checked  by  Arsenicum.  The  paralytic 
affection  to  which  allusion  has  been  already  made,  rendered 
every  attempt  to  place  the  leg  in  an  easy  position  by  means 
of  cushions  or  splints,  while  the  patient  lay  on  his  back,  utterly 
hopeless.  He  spent  the  night  lying  on  the  left  side,  and  during 
the  day,  either  sat  or  lay  on  a  sofa  on  the  right  side.  Although 
a  recumbent  position  was  most  desirable,  the  paralysis  gave 
rise  to  great  restlessness,  and  relief  was  frequently  sought  in  a  sit- 
ting posture.  The  nocturnal  left  decubitus  produced  a  large  blue 
threatening  looking  patch  on  the  left  trochanter,  which  I  covered 
with  Arnica  lotion,  lint,  a  pad  of  wadding,  and  oiled  silk  firmly 
secured  with  adhesive  plaister.  Slight  haemorrhage  occurred  one 
morning  from  a  small  vessel  imder  the  sloughy  mass,  which 
was  quickly  repressed  by  the  application  of  turpentine.  Matters 
progressed  very  gradually,  but  steadily  in  this  manner  till  the 
beginning  of  September.  There  was  little  change  in  the  pulse, 
naturally  a  slow  one;  the  patient  slept  a  good  deal,  as  had 
been  his  habit  in  health ;  much  nourishment  was  taken  in  the 
form  of  strong  beef  tea,  jelly,  pounded  meats,  claret,  port  wine, 
and  brandy.  His  daUy  routine  was  to  get  out  of  bed  between 
nine  and  ten ;  after  going  through  his  ordinary  toilet,  which  he 
strongly  objected  to  curtail,  and  being  dressed  in  his  usual 
costume,  he  breakfasted    and  lay  on  the    sofa.     After   soma 


32()  Case  of  Omigreiia  Senilis. 

rej^ose  his  leg  was  dressed,  and  he  transacted  business,  frequently 
of  great  importance,  and  requiring  considerable  deliberation 
with  his  secretary,  and  received  liis  brotlier  diocesans,  or  any  of 
his  clergy  who  came  to  visit  him.  He  next  took  an  airing  in 
the  grounds  in  a  Bath  chair,  and  then  lay  on  the  sofa,  either 
sleeping  or  listening  to  reading,  always  preferring  some  book 
of  a  theological  or  scientific  kind.  Natural  history  was  a 
favourite  subject,  and  he  manifested  great  interest  in  the  in- 
cidents of  the  American  war,  and  other  leading  topics  of  the 
day.  His  intellect  and  memory  maintained  their  power  and 
clearness  as  unclouded  as  they  had  ever  been.  Being  very 
averse  to  relinquish  his  normal  habits,  he  had  himself  lifted 
into  a  wheeled  chair,  and  took  his  place  at  the  dinner-table. 
In  the  evening  he  lay  on  the  sofa,  listening  to  music,  which  he 
much  enjoyed,  or  played  at  chess  or  backgammon.  It  may 
easily  be  imagined  what  a  deep  interest  was  taken  in  his  case 
by  his  numerous  friends,  and  the  many  prelates  and  clergy 
who  venerated  his  Grace.  Innumerable  were  the  panaceas  for 
"sore  legs"  suggested  and  urged  upon  him,  not  merely  by 
letter  but  pei-sonally,  and  most  pressing  were  the  solicitations 
that  he  would  give  up  "  QiLackery"  and  have  a  "  regular  surgeon.'* 
His  reply  to  these  importunities  was  characteristic  and  con- 
clusive. Taking  an  opportunity  when  a  right  reverend  prelate 
and  several  minor  dignitaries  with  myself  were  present,  he  said  : 
"  I  have  very  many  kind  friends,  each  of  whom  suggests  a 
separate  mode  of  treatment  or  remedy ;  I  can  make  use  of  but 
one,  and  having  made  my  selection,  must  be  in  a  minority." 

Alter  frequent  consultations  with  Dr.  Blythe,  and  the  an- 
nouncement of  our  joint  opinion,  as  to  the  imfavourable  nature 
of  the  case  and  the  probable  result,  it  was  determined  to 
obtain  the  advice  of  Professor  Henderson,  who  having  been 
telegraphed  for,  saw  the  Archbishop  on  the  9th  of  September. 
At  this  time  the  sore  extended  across  the  back  of  the  foot 
from  one  malleolus  to  the  other ;  the  tendo  achillis,  and  all  the 
structures  down  to  the  bones,  were  destroyed  from  the  heel  six 


Case  of  Oangrena  Senilis,  327 

inches  up  the  leg.  The  foot  was  red  and  cedematous,  the  calf 
enonnously  swollen,  of  a  deep  purple  red,  with  two  large 
yellow  bullae  on  the  centre  of  the  calf,  and  a  black  patch  had 
appeared  on  the  front  of  the  leg  over  the  tibial  muscles. 
There  was  a  large  blue  patch  on  each  trochanter,  surrounded  by 
vesicles,  a  similar  spot  on  the  left  scapula,  and  several  bluish  spots 
on  the  toes  of  both  feet  from  pressure  against  the  other  limb 
while  lying.  The  pulse  had  become  quick  and  feeble,  the 
tongue  dry,  and  there  was  occasionally  severe  pain  in  the 
ankle  and  calf  of  the  leg.  Such  an  array  of  symptoms  in  a 
broken  down  constitution  at  the  age  of  seventy-six,  notwith- 
standing the  soundings  of  the  heart  and  lungs,  impressed  Dr. 
Henderson  most  unfavourably,  and  a  fatal  result  was  prog- 
nostigated  as  probable  in  a  week  or  ten  days.  He,  however, 
recommended  a  less  stimulating  diet,  claret  alone,  instead  of 
port  wine  and  brandy,  and  some  farinaceous  food  and  beef 
tea.  Mercurius  6  was  the  medicine  selected.  On  the  following 
day,  the  whole  leg  up  to  the  knee  was  swollen,  tense  and 
^^oS7'  I  enveloped  the  limb  in  cotton  wadding,  covering  the 
sloughs  with  a  weak  solution  of  carbolic  acid.  A  water  bed 
was  procured,  and  his  Grace  agreed  to  forego  his  usual  toilet 
and  confine  himself  to  the  water  bed.  The  symptoms  of 
prostration  did  not  progress,  and  in  a  few  days,  matter  of  a 
most  oflFensive  smell  and  brown  colour  was  evacuated  by  several 
incisions,  a  line  of  demarcation  formed  at  either  side  of  the 
calf  and  below  the  popliteal  space,  and  from  day  to  day  the 
skin  and  large  muscles  of  the  calf  separated  piecemeal,  leaving 
a  clean  granulating  surface  from  below  the  knee  to  the  heel.  This 
was  all  accomplished  without  haemorrhage  or  diarrhoea.  There 
was  a  good  deal  of  nocturnal  fever  and  some  slight  delirium, 
which  Belladonna  and  Hyosciamus  relieved.  The  local  change 
was  not,  however,  followed  by  any  improvement  in  the  con- 
stitutional symptoms,  and  debility  very  gradually  increased 
feam  day  to  day.  The  black  patches  on  the  trochanter  re- 
Itained  in  statu  quo,    and  neither  spread,  noi   didi  \\i^  ^^xS^ 


328  Case  of  Ganjrena  Senilis. 

l^afhrT-like  sloughs  separate.  The  grannlations  on  the  leg 
amiliiwA  florid,  and  the  edges  in  some  places  showed  an  in- 
clinutioii  to  fonn  skin.  lu  the  first  week  in  October  the 
t()ii;jti(j  beraino  drier,  deglutition  and  articulation  became  more 
(iUi\  iiumi  (liilicult,  and  were  only  performed  by  the  strong  effort 
of  a  will.  Still  the  intellect  remained  dominant  and  nndonded 
iiH  v\rr.  It  wuH  a  struggle  between  mind  and  matter.  On 
Mm?  (Jill  OcAaAh^t,  this  state  of  things  had  so  far  increased  that 
iiii,i<Milfiliini  bc'ciiino  impossible,  yet  by  a  negative  or  afl&rmatiye 
MJ^jii,  liJH  (Inuuj  was  still  able  to  express  his  wishes  to  his 
iiilt'ndmiiM.  It  liad  been  a  frequently  expressed  wish  during 
hi'ullli,  wImmi  c()nv(u\sing  on  the  subject  of  dissolution,  that  he 
mIhiuM  not  outlive  his  intellect;  and  most  fully,  and  it  maybe 
mu«l,  |ininlully,  was  that  wish  accomplished.  On  the  morning 
nf  th(»  81  h,  at  ton  minutes  to  twelve,  the  struggle  quietly 
i'l«»r.tM|. 

Tlio  innujMliato  termination  was  to  a  certain  extent  un- 
r\luM'l^^(l,  noiH^  of  tlu3  usual  signs  of  approaching  dissolution 
liuvih^  lu^tMi  obHiM'vod.  It  was  discovered  on  my  arrival,  ten 
iniimlpM  iiriprwanlH,  that  a  small  vessel  in  the  leg  had  opened, 
nihl  MtiMl('i(»nt  ha»nu)rrlia)j[o  had  taken  place  to  extinguish  the 
llu'lNnriMf"  lluino  that  might  otherwise  have  smouldered  on  for 
niiulhor  tNsniity-four  hours. 

I''rnnj  Iho  coiinuoiuunuont  the  disease  had  been  regarded  as 
Monih\  (lani^TtMic,  do|MMuhuit  on  partial  or  complete  obstruction 
of  m\\\o  (»r  tlu^  arlcu'ial  branches  supplying  the  limb;  an  in- 
ilirttiui^t  omnlliko  haiHlness  was  detected  in  the  popliteal  space, 
but  tu>ul(l  not  1)0  tracod  down  the  limb.  Stethoscopic  exami- 
uuliou  fiUlod  to  dirtcovor  any  disease  of  the  heart  or  large 
nrtorial  truukH,  and  the  lungs  were  quite  sound.  In  fact,  his 
(iraoo  frotiuoutly  i^emarked  that  he  did  not  know  what  a  cough 
>vaa. 

To  the  mechanical  origin  of  the  disease  one  feels  inclined 
to  attribute  the  absolute  powerlessness  of  all  the  remedies 
proscribed,  not  one  of  which  appeared  in  any  way  to  impress 


Case  of  Oangrena  Senilis,  329 

the  principal  malady,  although  the  tendency  to  diarrhoea,  as 
well  as  the  fever  and  delirium,  all  yielded  to  the  remedies  ad- 
ministered for  them.  The  healthy  suppurative  process  which 
set  in  subsequent  to  the  visit  of  Professor  Henderson,  and  the 
total  cessation  of  the  spread  of  the  gangrene,  were  very  re- 
markable, and  may  possibly  be  attributable  to  the  completion 
of  the  obliteration  of  the  arteries  supplying  the  calf,  and  the 
establishment  of  a  collateral  circulation,  which  vitalised  the 
deeper  layer  of  muscles  and  the  front  of  the  leg.  As  no 
anatomical  examination  of  the  limb  was  permitted,  this  must 
remain  a  matter  of  speculation ;  but  it  gave  rise  to  the  feeling 
that  had  this  change  been  brought  about  at  an  earlier  period, 
before  the  vital  energy  had  been  so  lowered,  there  might  have 
been  some  chance  of  at  least  a  partial  recovery. 

DISCUSSION. 

Mr  Teldham  rose  simply  to  thank  Dr.  Scriven  for  his  very 
interesting  communication;  for,  as  the  Chairman  had  already 
observed,  it  was  not  calculated  to  elicit  much  discussion  of  a 
therapeutic  character.  Such  a  communication  from  a  gentleman 
who  enjoyed  the  privilege  of  frequent  intercourse  with  such  a 
man  as  Dr.  Whately,  could  not  fail  to  be  deeply  interesting, — 
and  Dr.  Scriven  had  ably  related  what  he  had  observed  of  the 
closing  scene  of  the  great  man's  life.  Dr.  Whately's  reply  to  the 
allopathic  physician,  was  a  masterpiece  of  writing — ^too  much 
much  could  not  be  said  in  its  praise.  As  regards  the  medical 
part  of  the  paper,  he  (Mr.  Yeldham)  thought  Dr.  Scriven  was  a 
little  unreasonably  disappointed  at  the  failure  of  his  treatment. 
What  could  he  have  expected  ?  Unless  they  could  stop  the 
course  of  time,  and  reverse  the  order  of  nature,  they  could 
scarcely  hope  to  do  much  in  arresting  the  progress  of  Gangrena 
Senilis,  which  arose  from  simple  failure  of  vital  power  from  the 
lapse  of  years.  The  Archbishop  could  scarcely  be  said  to  have 
ssiiik  from  disease — ^his  was  simply  a  prolonged  death — dying  at 
the  extremities,  as  an  aged  tree  dies  first  in  its  branches.  Ex- 
cept by  nutrition,  and  judicious  stimulation,  they  could  do  but 
little  to  arrest  the  death  of  old  age.  Therefore,  in  the  present 
case,  he  would,  perhaps,  have  given  the  bark  and  ammonia, 
if  he  had  given  them  at  all,  in  larger  doses,  purely  as  stimulants. 

Dr.  KiDD  said,  that  the  memorandum  written  by  the  Arch- 
bishop, illustrated  the  largeness  of  his  mind,  and  the  perfect 


iW  Case  of  Gangrena  Senilis, 

vouMonoQ  he  had  in  the  law,  "  similia  simUibtcs.**  The  case 
was  unlortunately  oue  of  those  which  medical  art  of  any  school 
coiilvl  not  ouiv.  The  gangrene  was  caused  by  obliteration  of  the 
artt'iit's ;  t\\o  result  of  degeneration,  which  nothing  could  cure. 
lu  surh  cast's  Dr.  Kidd's  experience  was  in  favour  of  keeping 
the  ^^'iiugn'uous  surface  j)erfectly  dry — avoiding  poultices,  fomen- 
tations, ami  h)tion3 — the  surface  dusted  with  finely  pulverized 
ilrv  Vv'i:»'tiil>lo  charcoal,  three  or  four  times  a  day,  and  washed 
with  wariu  si>ft  water,  not  oftener  than  once  or  twice  in  twenty- 
four  hours.  The  limb  should  be  bandaged  with  a  roller  of 
l)i>nimctt  llaiiuel,  which  gives  a  gentle  elastic  support  to  the 
iiniil'atit>n.  lu  sucli  cases  it  is  most  important  to  bear  in 
luiiul  the  nuu'lianical  cause  of  the  disease,  and  therefore  to  pro- 
mi»te  tho  oiivuhitiou  by  gentle  shampooing  of  the  limb  in  a 
iliriMtiou  upwards,  and  by  raising  the  leg  on  an  inclined  plane, 
avoiviing  standing  and  walking,  but  keeping  the  patient  fre- 
tiucntly  out  i>f  doors  on  a  reclining  couch  with  the  limb  raised. 
fhani^o  of  air  to  the  seashore  helps  to  delay  the  progress  of 
the  disease.  The  medicine  which  seemed  most  truly  homceo- 
pathie  to  the  cast^  was  Secale,  and  to  give  the  full  benefit  of  the 
law  aim  ilia  similibus  to  his  Grace,  this  medicine  should  have 
bet^i  given  in  the  first  decimal  trituration,  and  the  mother 
tincture,  as  well  us  in  the  thinl  dilution.  Dr.  Henderson's  advice 
ahvuit  vliet  was  most  judicious.  Much  good  is  often  gained  by 
Uvh^ptiuij:  a  light  diet  and  weaker  stimulants.  In  a  weak  state 
of  health,  the  stomach  and  bhn^d  became  weighed  down,  so  to 
speak,  anil  oppi^esst^d  by  too  strong  nourishment  or  too  strong 
stimulants.  Dr.  Kiild  narrated  a  case  of  gastric  fever  with 
ga:igreni>us  \dceration  of  the  legs,  in  an  old  lady  aged  seventy- 
tnght,  when^  aggravation  invariably  followed  the  use  of  solid 
fov>.l  of  any  sort,  whoivas  on  clear  beef  tea  and  milk  and  water, 
with  a  fi'oe  use  of  sherry,  the  old  lady  perfectly  recovered,  to 
tht^  astonishment  of  her  friends,  who  had  a  hard  task  to  carry 
out  Wus  instructions  of  refusing  solid  food,  which  the  patient 
asktul  for. 

Dr.  MoKOAN  did  not  agree  with  Dr.  Scrivens's  treatment  of 
tlh)  cast).  No  surgeon  would  have  employed  the  measures  he 
adopted.  The  meilicines  best  indicated  were  Secale  and  Arseni- 
cum. Doubtless,  under  any  treatment,  the  case  must  have 
ttMiuinattnl  fatiilly.  The  cause  of  death  was  probably  ossifica- 
tion of  the  arteries.  He  sometimes  found  even  the  coronary 
arteries  produce  death  of  remote  parts.  He  (Dr.  Morgan) 
agrf>tHl  in  all  the  treatment  suggested  by  Dr.  Kidd. 

Mr.  Buck  thought  all  must  deeply  regret  the  loss  of  this 
truly  estimable  and  staunch  supporter  of  our  cause ;  it  was  rare 
to  tind   one  who  would  so  boldly  and  unswervingly  persist 


Case  of  Oangrena  Senilis.  331 

against  a  mighty  odds  in  maintaining  and  defending  this,  which 
he  felt  and  knew  to  be  a  great  and  imperishable  truth ;  fairly 
might  we  wish  his  life  to  have  been  spared  some  few  years 
longer,  to  have  still  given  his  powerful  aid  to  still  the  opposition 
with  which  we  are  at  times  assailed.  With  regard  to  the  treat- 
ment of  the  case,  he  did  not  see  that  much  could  be  done,  but 
agreed  with  Dr.  Eadd  as  to  the  treatment  of  gangrene,  by 
supporting  the  limb,  keeping  it  dry,  and  giving  such  patient 
fresh  air.  Believed  Secale  to  be  a  most  useful  remedy;  yet 
feared,  in  the  case  of  the  Archbishop,  whatever  plan  had  been 
pursued,  the  result  would  have  been  the  same. 

Dr.  KussELL  said,  he  regretted  very  much  that  Dr.  Scriven 
was  unable  to  be  present.  He  considered  it  hardly  fair  to  dis- 
cuss the  treatment  of  a  case  in  the  absence  of  the  practitioner 
who  treated  it ;  for  in  the  management  of  every  case  there  was 
always  something  more  or  less  peculiar  to  it,  which  frequently 
required  that  the  general  rules  laid  down  in  books  as  applicable 
to  the  class  to  which  it  belonged  should  be  modified,  or  even 
altogether  reversed.  It  might  not  be  known  to  all,  that  besides 
having  an  excellent  medical  education.  Dr.  Scriven  had  enjoyed 
the  advantage  of  being  an  apprentice  of  the  great  anatomist  and 
excellent  surgeon,  Mr.  Harrison,  and  had  the  best  opportunities  for 
acquiring  a  thorough  knowledge  of  surgery.  This  stood  him  in 
good  stead  in  the  present  instance,  when,  owing  to  the  intolerant 
measures  of  the  College  of  Surgeons  of  Ireland,  he  was  debarred 
the  benefit  of  the  aid  of  a  professed  surgeon.  The  fact  that  in 
most  trying  circumstances  he  succeeded  in  retaining  the  fullest 
confiilence  of  the  Archbishop  and  his  family,  was  the  highest 
testimony  we  could  desire,  to  the  tact  and  judgment  both  he  and 
Dr.  Bly the  must  have  displayed ;  and  we,  as  a  body,  may  be  very 
thankful  that  we  had  the  advantage  of  being  so  well  represented 
in  Dublin. 

Dr.  Chapman  (in  the  chair). — ^The  case  related  by  Dr.  Scriven 
is  one  of  great  interest,  personal,  however,  rather  than  pro- 
fessional. The  illustrious  patient  deserved  all  respect  from  his 
contemporaries,  not  only  on  account  of  his  eminent  intellectual 
faculties  and  of  his  moral  excellence,  but  for  his  consistent  as- 
sertion of  his  liberty  of  human  thought  and  of  human  action, 
for  the  benefit  of  mankind,  and  for  the  advancement  of  know- 
ledge and  of  science  in  whatever  direction.  There  is  no  scope 
for  discussion  on  the  subject  of  Senile  Oangrena.  The  oil  that 
supports  the  flickering  flame  is  going  out,  and  soon  goes  out.  It 
cannot  be  supplied  in  such  cases ;  whether  it  be  embolism,  or 
arterial  obliteration,  the  result  is  the  same.  The  practice  of  Dr 
Scriven  has  been  objected  to  by  one  or  two,  in  his  treatment  of 


332  Case  of  Oangrena  Senilis, 

this  case.  He  is  not  present  to  show  why  he  did  this  or  that; 
or  why  he  omitted  to  do  that  or  this.  He  had  an  excellent 
medical  and  surgical  education  at  Dublin  and  Edinburgh,  and 
partly  in  London. — ^We  doubt  not  he  did  his  best  to  alleviate 
wliat  lie  could  not  cure ;  and  the  patient  and  the  family  were 
thoroughly  satisfied  with  and  thankful  for  his  treatment.  The 
physician  and  the  patient  showed  equal  moral  courage;  the 
former  had  to  show  patience,  and  unfailing  temper,  and  con- 
scientious reliance  on  his  own  resources  ;  the  latter  had  to  resist 
the  impatience  of  anxious  friends,  and  to  die  in  and  for  the  main- 
tenance of  the  medical  creed,  to  the  practice  of  which  he  had 
for  many  years  trusted  his  own  mortal  life,  and  the  lives  of  others 
dearer  to  him  than  his  own.  There  is  no  use  in  giving  cases, 
exemplifying  the  specific  action  of  such  remedies  as  Arsenicum, 
Bellado7ina,  Armonium,  Carhonicum,  China,  Carbo  Animalis, 
Carho  Vegetahilis,  &c.,  or  of  the  advantages  derivable  from 
poultices  of  yeast  and  charcoal.  The  Chairman  had  seen  his 
full  share  of  cases  of  the  gangrene  of  age.  He  saw  a  few  years 
ago  a  case  of  this  sort,  remarkable  from  the  presentments  of  the 
affected  limb.  From  the  upper  part  of  the  thigh  to  the  toes,  the 
integuments  presented  the  appearance  of  half-tanned,  of  half- 
charred  leather.  There  was,  in  this  case,  the  same  uneasy 
restlessness  which  is  observable  in  those  that  go  out  from 
"  Bright's  Disease  of  the  Kidney."  The  best  palliative  in  this 
instance  was  brandy  in  small  but  frequently  repeated  doses. 
Another  case : — A  gentleman,  not  so  very  old  in  years,  had 
gangrene  of  several  toes  of  one  foot ;  he  was  a  plethoric  man, 
full  of  the  consciousness  of  active  life.  He  was  told  that  he 
was  to  die ;  he  said  "  I  don't  believe  it,  I  don't  feel  like  a  dying 
man."  The  final  issue  was  rapid  in  this  case ;  he  departed  this 
life  in  a  few  weeks.  In  this  case,  alcohol,  frequently  repeated, 
but  in  small  quantities,  was  the  chief  palliative.  There  was  the 
same  restlessness  in  this  case  as  in  the  preceding.  Yet  another 
case  : — An  old  lady,  near  80,  had  gangrene  of  one  of  her  toes. 
The  dead  blackness  disappeared,  but  her  friends  were  told  the 
case  was  nevertheless  mortal,  and  she  went  out  Kestlessness  in 
this  case  also  was  the  predominant  symptom.  We  grow  old 
while  we  speak.  "  Bum  loquimur  senescimvs"  The  glory  of  a 
mortal  life  fades  away ;  but  in  the  case  of  worthies  something 
remains. 

"  The  actions  of  the  just 
Smell  sweet,  and  blossom  in  the  dust, 

From  the  time  he  adopted  Homoeopathy,  to  his  last  breath — a 
period  of  many  years — ^Whately  was  a  staunch  HomcBopathist. 
He  never  wavered ;  he  gave  noble,  simple,  honest  testimony  to 
his  conviction  that  Hotnoeopathy  was  the  law  of  drug  healing. 


Observations  on  afeio  Local  AncestJietics.  333 

He  went  out,  and  was  satisfied  to  go  out,  under  the  banner  of  our 
law  of  therapeutics.  All  honour  to  his  memory !  All  praise  to 
his  honesty !  His  name  will  live  after  him — ought  to  live  so 
long  as  the  English  language  endures,  as  a  ripe  scholar,  a  pro- 
found reasoner,  an  exact  logician — 

''  Quia  desiderio  sit  pudor  aut  modus 
Tarn  carl  capitis  ?  ** 


OBSEEVATIONS  ON  A  FEW  LOCAL  AN^aiSTHETICS. 
By  Dr.  Eugene  Cronin. 
I  was  induced  a  short  time  ago  to  examine  the  subject  of 
local  anaesthetics,  by  seeing  the  frequency  and  indiscrimination 
with  which  Chloroform  is  now  used ;  and  from  having  in  two 
or  three  instances  witnessed  the  bad  effects  produced  by  it  in 
some  of  the  minor  operations.  Operations  which  but  for  the 
nervousness  of  the  patient,  might  have  been  performed  with 
comparatively  little  suffering,  and  which  I  think  but  for  the 
impatience  of  the  surgeon,  would  have  been  rendered  sufficiently 
painless  by  the  employment  of  a  local  anaesthetic.  Every  agent 
by  which  general  anaesthesia  is  induced  produces  a  powerful 
impression  upon  the  system,  and  may  occasion  dangerous  con- 
sequences when  freely  and  carelessly  administered ;  and  even 
with  the  greatest  care  it  appears  certain  that  the  inhalation  of 
Chloroform  is  in  some  cases  inevitably  fatal,  and  Dr.  J.  Amott 
has  statistically  proved  that  the  mortality  after  operations  has 
materially  increased  since  the  introduction  of  Chloroform. 
The  title  of  this  communication  shows  that  I  have  been  engaged 
only  with  some  local  anaesthetics,  for  of  course  there  are  many 
agents  of  this  nature.  My  investigations  have  been  confined 
to  Chloroform  in  liquid  and  vapour,  to  Chloroform  and  Acetic 
Acid  according  to  the  new  form  of  chloracetisation,  to  freezing 
mixtures,  and  lastly  to  Carbonic  Acid  Gas.  These  of  course 
can  only  be  expected  to  act  in  superficial  cases,  yet  in  private 
practice  the  boon  of  being  freed  from  the  horrors  of  cold  steel, 


334  Observations  on  a  few  Local  Ancesihctics. 

without  encouutering  those  of  the  inhalation  of  Chloroform,  is 
no  small  one.  I  am  inclined  to  believe  these  various  articles 
do  not  produce  their  effects  till  an  action  amounting  to  one  of 
revulsion  or  counter-irritation  occurs,  since  a  varying  amount  of 
irritation  in  all  cases  precedes  the  anaesthesia:  I  mean  by 
counter-irritation  the  production  upon  the  surface  of  a  powerful 
impression,  which  seems  to  be  capable  of  arresting  or  diverting 
as  it  were  the  attention  of  the  system,  and  thus  for  a  time 
checking  or  relieving  a  morbid  process. 

It  lias  frequently  been  urged  that  "  ancesthetic  "  is  inapplic- 
able and  untrue  with  regard  to  Chloroform;  for  my  part  I  could 
never  see  the  force  of  the  argument  used  against  its  employment. 
Pit)tessor  Hughes  Bennett  states  his  argument  against  the  cor- 
rectness of  the  applicability  of  the  word  anaesthetic  to  Chloro- 
form thus  : — "  Looking  at  the  meaning  of  the  word  anaesthesia 
I  find  it  implies  a  want  of  feeling,  hence  as  Chloroform  destroys 
the  sense  of  touch  by  first  producing  loss  of  consciousness,  the 
term  auiosthesia  is  inapplicable,  and  is  only  employed  as  a 
'*  mask  to  conceal  its  true  action  as  a  stupifying  agent."  And 
again,  in  his  work  on  the  Principles  and  Practice  of  Medicine, 
page  432,  he  says :  "The  modem  practice  of  depriving  persons 
of  coiusoiousuoss  in  order  for  a  time  to  destroy  sensation,  has 
boon  very  much  misunderstood,  in  consequence  of  such  remedies 
having  boon  erroneously  and  unscientifically  denominated  anaes- 
thotics  ;  in  fact  they  in  no  way  influence  local  sense  of  touch, 
tiioir  action  is  altogether  central,  and  hence  the  danger  which 
ofton  attends  their  action." 

I  n  answer  to  Dr.  Bennett's  argument  that  the  word  anaesthetic 
luoauvM  a  want  of  feeling,  I  would  say  that  that  translation  is 
l^ulially  cori-ect,  but  if  we  look  at  the  Greek  verb  di(T0aVo/iac  we 
Uuvl  that  in  its  strict  and  true  sense  it  means,  "I  perceive  with 
tho  aouHOj*,"  that  the  cognate  aiadnfris  implies  "  perception  by 
tho  {ioua^i44»"  and  the  word avntrdritris  itseU,  means  "stupidity," 
with  its  oovrt^iipouding  verb  Ayaitrdrirekt "  to  be  senseless,"  or 
**  stui)id." 


Observations  on  a  few  Local  Ancesthetics,  335 

I  shall  here  give  the  results  of  a  few  experiments  tried  upon 
myself,  accompanied  by  a  few  cases : — 

ExperiTrunt  1. — I  put  about  a  drachm  of  Chloroform  in  a 
wide  tube  and  applied  it  to  my  forearm ;  after  the  application 
had  been  continued  for  two  or  three  minutes,  I  experienced 
tingling  and  slight  feeling  of  heat ;  at  the  expiration  of  five 
minutes,  on  removing  the  tube  the  cuticle  looked  of  a  pale  pink, 
the  line  of  pressure  from  the  edges  of  the  tube  were  very  dis- 
tinct, sensibility  was  in  no  way  disturbed.  The  tube  was  im- 
mediately reapplied,  and  a  smart  burning  sensation  was  produced 
which  increased  in  severity  for  about  three  minutes;  the 
sensation  then  began  to  diminish  and  a  numb  feeling  supervened. 
On  removing  the  glass,  after  fifteen  minutes  application,  the 
cuticle  looks  pale,  and  the  ring  of  the  tube  is  surrounded  by  aa 
erethematous  areola ;  on  pricking  the  spot  with  a  needle,  sen- 
sation was  quite  absent  until  the  point  penetrated  the  cuticle, 
when  a  slight  amount  of  sensation  became  apparent ;  no  blood 
followed  for  nearly  half  a  minute  :  as  the  numbness  passed  away 
burning  and  tingling  returned,  remaining  super-sensitive  for 
some  hours. 

Experiment  2. — Chloroform  Vapour.  I  applied  the  mouth 
of  a  tube  containing  about  1  drachm  of  chloroform  to  my  arm, 
holding  the  lower  part  of  the  tube  in  my  hand  to  induce 
freer  evaporation;  in  five  minutes  the  skin  became  slightly 
reddened,  and  I  experienced  a  slight  tingling  sensation,  which 
merged  into  one  of  irritation,  but  never  amounted  to  pain.  On 
removing  the  glass  on  the  expiration  of  fifteen  minutes,  sensi- 
bility was  decidedly  diminshed,  though  not  abrogated ;  it  speedily 
returned,  no  unpleasant  effect  remaining. 

Case  1. — ^In  a  very  distressing  case  of  neuralgia  of  the 
scalp  that  came  under  my  notice,  lint  dipped  in  chloroform  was 
applied  to  the  scalp,  the  whole  carefully  covered  with  oilsilk, 
to  hinder  too  rapid  evaporation,  this  gave  entire  relief  from 
pain,  which  continued  for  some  hours,  allowing  the  patient  to 


33  6  Observations  on  a  few  Local  AncestheHcs, 

get  some  refreshing  sleep.     A  slight  amount  of  irritation  of 
the  skin  being  the  only  inconvenience. 

Case  2. — In  a  case  of  frontal  neuralgia,  the  application  of 
the  liquid  chloroform  gave  complete  relief  in  about  t^n  minutes; 
but  in  this  case,  local  irritation  and  diminished  common  sensi- 
bility resulted.  In  the  same  case,  on  another  occasion,  the 
vapour  of  chloroform  removed  the  neuralgia  in  about  fifteen 
minutes,  the  common  sensibility  of  the  part  was  not  at  all 
interfered  with,  nor  were  there  any  signs  of  local  irritation. 

Case  3. — I  watched  a  case  of  carcinoma  uteri  for  some 
time,  in  which  the  vapour  of  chloroform  was  being  used  as  a 
local  application,  it  being  brought  into  contact  with  the  os  by 
means  of  an  elastic  tube  fastened  at  one  end  to  a  flask  con- 
taining fluid  chloroform.  It  generally  gave  great  relief  from  the 
harrassing  pain,  but  I  found  that  its  good  effects  could  not  be 
always  implicitly  relied  upon,  and  I  have  heard  the  same 
remarked  in  other  cases  similarly  treated,  the  pain  being  at  one 
time  removed,  in  others,  only  slightly,  or  not  at  all  relieved. 
For  this  I  know  no  explanation. 

Experiment  3. — Chloroacetisation.  During  the  early  part  of 
last  year,  I  noticed  that  a  new  mode  of  producing  local  anaes- 
thesia, had  been  brought  before  the  French  Academy,  by  M. 
Toumie,  who  calls  the  process  "  Chloroacetisation,"  and  bases  its 
merits  on  the  rapidity  with  which  anaesthesia  is  produced,  and 
the  slight  inconvenience  caused  to  the  patient.  I  was  much 
interested  in  reading  M.  Toumi^'s  communication,  and  deter- 
mined to  give  it  a  fair  trial.  The  process  is  as  follows  : — 1  3 
of  glacial  acetic  acid,  and  45  m  of  chloroform  are  put  into  a 
tube,  and  the  mixture  applied  to  the  sound  skin ;  the  part  to 
be  acted  upon  being  marked  off"  by  a  piece  of  diachylon  plaster. 
The  mixture  to  be  kept  at  the  temperature  of  the  hand.  Under 
these  circumstances,  M.  Toumi^  says  anaesthesia  is  to  be  looked 
for  in  about  flve  minutes.  I  applied  a  mixture  prepared  as 
above  to  the  inside  of  my  fore-arm.  It  immediately  caused 
a  burning  sensation,  followed  in  about  twenty  seconds  by  most 


Observations  on  a  few  Local  AnofHheties.  887 

acute  smarting,  increasing  rapidly  to  the  most  excruciating 
pain,  and  compelling  me  to  remove  the  tube,  and  apply  cold 
water  for  relief;  the  cuticle  was  reddened  and  blistered,  the 
smarting  continued  severe  afterwards,  and  the  part  looked  as  if 
it  had  been  severely  stung  by  stinging  nettles,  indeed,  the  pain 
was  very  similar  to  that  produced  by  them.  It  would  have 
been  quite  impossible  to  have  borne  the  application  of  this 
mixture  for  five  minutes,  as  M.  Tourni^  desires. 

Chloroform  seems  to  assist  the  action  of  the  acetic  acid 
severe  enough  in  itself,  by  favouring  its  rapid  absorption,  and 
we  know  that  a  solution  of  Belladonna  in  chloroform,  acts 
with  tenfold  greater  rapidity  than  an  ordinary  one. 

Experiment  4. — I  next  tried  the  effects  of  the  vapour  of  the 
acetized  chloroform,  the  which  was  to  produce  redness,  heat, 
and  tingling,  in  five  minutes,  which  gradually  increased  up  to 
stinging,  when  I  removed  the  glass.  No  anaesthesia  was 
induced  in  either  of  these  cases. 

Eocperiment  5. — Ice  as  a  local  anaesthetic. 

This  method  of  producing  anaesthesia  was  introduced  by  Dr. 
J.  Amott,  and  is  one  of  the  most  successful  By  making  a 
mixture  of  2  parts  of  pounded  ice  and  one  of  salt  in  a  muslin 
bag,  and  applying  it  to  the  skin,  I  have  in  fifteen  minutes  pro- 
duced the  most  perfect  local  insensibility;  the  skin  acquires  a 
parchmenty  appearance,  and  becomes  hard  and  homy. 

Case  4. — I  have  seen  this  method  applied  in  two  instances 
to  cases  of  hernia,  one  of  which  occurred  in  an  old  woman, 
and  was  of  the  femoral  variety ;  the  intestine  had  been  stran- 
gulated in  the  same  way  upon  a  former  occasion,  and  she  was 
operated  upon  while  under  the  influence  of  Chloroform.  The 
patient,  though  she  made  a  good  recovery,  suffered  from  that 
time  with  almost  continual  headache.  When  I  first  saw  the 
case,  the  taxis  had  been  employed  for  a  considerable  time  with- 
out any  good  result,  so  a  bag  of  ice  was  placed  over  the 
tumour,  and  kept  there  for  five  or  six  hours,  hoping  that  re- 
duction might  thus  be  effected ;  after  this,  the  taxis  wse  «%^\sk 


336  Observations  an  a  fmv  Local  AncBsthdics. 

tried  without  success ;  a  freezing  mixture  was  then  applied  and 
maintained  for  about  an  hour,  and  the  operation  for  reduction 
was  proceeded  with,  the  stricture  was  divided,  the  bowel  re- 
turned, and  a  suture  introduced,  without  giving  the  patient  any 
pain ;  she  made  a  good  recovery. 

Case  5. — ^The  other  case  was  that  of  a  man  suffering  from 
an  old  inguinal  hernia,  which  became  strangulated,  the  tumour 
was  large ;  the  taxis  was  tried,  and  failed,  both  before  and  after 
the  application  of  ice ;  ice  and  salt  were  maintained  in  contact 
with  the  tumour  for  about  an  hour,  and  perfect  anaesthesia 
being  produced,  the  case  was  operated  upon,  and  the  gut  re- 
turned ;  no  pain  was  experienced  during  the  operation. 

In  this  case  the  patient  died  three  days  afterwards,  from 
peritonitis,  produced  by  the  very  severe  strangulation  of  so 
large  a  portion  of  gut  and  omentum. 

Case  6. — A  friend  of  mine  had  a  large  number  of  external 
haemorrhoids  removed,  insensibility  being  produced  by  the  use 
of  a  freezing  mixture ;  he  experienced  no  pain,  and  only  a  few 
drops  of  blood  were  lost.  I  consider  in  cases  requiring  opera- 
tion, that  ice  is,  without  doubt,  the  most  valuable  means  for 
inducing  local  anaesthesia,  from  its  admitting  of  simple  applica- 
tion, and  from  the  very  small  amount  of  haemorrhage  that  oc- 
curs in  all  cases  in  which  it  is  employed ;  and  I  think  that  all 
the  following  operations  might  be  painlessly  performed  by  this 
method : 

1.  The  removal  of  small  superficial  tumours,  embracing 
malignant,  cystic,  benignant,  and  other  growths. 

2.  The  operation  for  the  reduction  of  paraphymosis. 

3.  The  operation  for  onychia. 

4.  The  opening  of  anthrax,  and  acute  and  chronic  abcesses, 
when  superficial 

5.  The  operations  for  the  various  kinds  of  hernia. 

6.  Excision  of  external  piles. 

Carbonic  acid  gas,  when  applied  to  the  healthy  akin,  pro- 
duces no  effect  beyond  a  slight  sensation  of  warmth,  but  I 


ObservatioTis  on  a  few  Local  AncestJietics.  339 

have  seen  very  good  results  from  its  local  application  in  cases 
of  cancer  of  various  parts,  especially  after  the  destruction  of  the 
cutaneous  surface;  when  it,  besides  relieving  the  pain,  neu- 
tralizes the  foefh(i  odour,  from  which  the  patients  suffer  almost 
as  much  as  from  the  pain  itself;  and  it  is  thus  a  great  boon 
to  those  about  them. 

In  three  cases  of  carcinovia  nteri,  and  two  of  cancer  of  the 
breast,  I  have  seen  it  used,  without  in  any  case  producing  un- 
pleasant results,  or  failing  to  give  reliet 

I  would  mention  that  it  is  better  to  use  sulphuric  acid  in 
the  preparation  of  carbonic  acid  gas,  for  when  the  hydrochloric 
is  employed  the  gas  requires  to  be  washed  before  being  brought 
into  contact  with  excoriated  parts,  being  apt  to  contain  hydro- 
chloric acid  in  vapour,  which  may  give  rise  to  considerable  irri- 
tation and  pain. 

DISCUSSION. 

Dr.  Wyld  thought  that  practitioners  of  Homoeopathy  were 
apt  to  neglect  the  use  of  local  anaesthetics.  He  had  repeatedly 
met  with  cases  of  neuralgic  pains,  which  had  not  yielded  to 
carefully  chosen  Homoeopathic  remedies  given  internally,  but 
which  had  yielded  at  once,  and  permanently,  to  the  application 
of  chloroform  liniment.  No  doubt  it  would  have  been  a  greater 
proof  of  skill  to  have  cured  such  cases  by  cleverly  selected 
medicines.  Still,  our  great  object  is  to  relieve  pain,  and  cure 
disease  as  quickly  as  is  consistent  with  safety.  To  heal  rapidly 
external  eruptions  by  external  applications,  is  often  dangerous ; 
but  the  healing  of  neuralgic  affections  by  externally  applied 
Anaesthetics,  was  always  a  safe  process,  and  frequently  a  success- 
ful one. 

Mr.  Cutmore  said — Dr.  Cronin's  paper  upon  anaesthetics  is  a 
very  interesting  one.  As  regards  chloroform,  it  is  a  great  boon 
in  the  practice  of  midwifery,  especially  at  the  point  where  the 
head  is  passing  over  the  perinenum,  and  the  anguish  is  greatest 
also  where  there  is  much  rigidity  of  those  parts.  But  I  think 
that  Homoeopathic  remedies  are  not  without  their  blessings  in 
this  kind  of  cases.  Gelseminum  Semperviren  is  of  that  class, 
and  if  given  in  drop  doses  of  the  3rd  dil.  it  acts  as  a  power- 
ful relaxor  of  all  mascular  fibre,  and  a  calmer  of  the  nervous 
system,  which,  at  those  times  is  a  great  boon  to  such  patients. 
I  have  given  it  for  some  time,  and  it  has  never  disappointed  me. 

22* 


840  ObuTvationB  on  a  few  Local  Afuesthitie$. 

There  is  another  medicine  which  I  place  great  reliance  upon, 
that  is  GonlaEhyllum,  and  I  think  it  equal  to  the  former,  hut  its 
action  uponttie  uterus  is  generally,  where  there  is  a  want  of 
expulsive  power,  rather  than  rigidity  of  the  os  uteri. 

Dr.  Drury  regretted  that  the  author  of  this  paper  was  not 
present  It  was  always  desirable,  that  those  who  favoured  the 
Society  with  their  opinions  should  have  the  opportunity  of  hear- 
ing what  was  said,  either  in  the  way  of  censure  or  praise; 
happily,  on  this  occasion,  there  was  no  room  to  find  fault,  on  the 
contrary,  the  enquiries  of  the  author  showed  a  large  amount  of 
careful,  steady  investigation,  resulting  in  a  very  interesting 
paper,  and  gave  promise  of  more  extended  researches  at  a  future 
day.  It  appeared  as  one  of  the  valuable  practical  results  of 
applying  cold,  with  a  view  to  produce  local  anaesthesia,  that 
haemorrhage  was  controlled  by  its  use,  the  value  of  this,  in 
many  operations  was  very  great,  facilitating  the  operation  and 
saving  the  patient's  strength.  Dr.  Cronin  had  spoken  of  Car- 
bonic acid  gas  as  an  agent  that  might  be  employed  with 
advantage.  In  its  condensed  form  it  was  valueless,  as  it  acted 
as  a  powerful  escharotic,  but  applied  as  a  gas  it  was  capable,  at 
times,  of  allaying  pain ;  it  was,  of  course,  in  many  cases  inappli- 
cable, but  it  had  been  used,  and  there  was  no  reason  why  it 
should  not  again  be  employed,  if  it  could  be  made  more  manage- 
able. Some  gentlemen,  it  was  said,  objected  to  the  use  of 
local  anaesthetics ;  unless  there  was  a  special  reason  in  any 
particular  Jcase,  it  seemed  to  him,  (Dr.  Drury)  that  in  many 
cases  their  use  was  very  desirabla  If  prompt  and  inmiediate 
relief  can  be  obtained  by  some  local  means,  in  no  way  affecting 
or  interfering  with  the  action  of  our  remedies,  there  could  be  no 
valid  reason  for  rejecting  such  aid.  If  a  patient  consulted  a 
medical  man,  with  painful  ulcer  of  the  rectum,  though  such 
might  be  cured  by  Homoeopathic  doses,  yet  if  a  division  of 
the  mucous  membrane  across  the  ulcer  secures  a  safe  and  speedy 
cure,  why  should  it  not  be  done  ?  Mr.  Cutmore  had  spoken 
highly  in  favour  of  Gelseminum  in  labour,  the  only  experience 
he  (Dr.  Drury)  had  of  it  in  such  cases,  was  in  a  case  of  Mr. 
Cutmore's,  where  he  had  given  it  to  prevent  abortion,  but  where 
the  patient  had  aborted  notwithstauding.  Dr.  Drury,  should, 
however,  say  that  he  saw  her  after  a  railway  journey,  which  waa 
not  calculated  to  keep  off  the  threatened  mischie£ 

Dr.  Eussell  said  he  hoped  Dr.  Cronin  would  pursue  the  line 
of  investigation  he  had  entered  on.  The  subject  was  full  of  in- 
terest; there  could  be  no  doubt,  that  if  for  the  general  narcotism 
produced  by  Chloroform  and  similar  agents,  we  could  substitute 
merely  local  insensibility,  the  gain  would  be  material  Dr. 
Hope,  professor  of  Chemistry,  in  Edinburgh,  used  to  describe 


Observations  on  afiw  Local  Anassthetm.  341 

Nitrous-oxide  as  afifording  an  elegant  debauch.  The  inhalation  of 
Chloroform  might  be  said  to  be  looked  upon  as  innocent  intoxi- 
cation. Intoxication  it  undoubtedly  was ;  it  has  all  the  stages — 
first  excitement,  next  insensibility,  and  lastly  maiatae,  and  fre- 
quently nausea  and  vomiting.  Chloroform  entered  the  blood, 
and  was  borne  to  the  brain,  on  which  organ  it  produced  it?  intoxi- 
cal  effects.  And  he  (Dr.  Eussell)  had  known  instances  of  pa- 
tients suffering  from  these  effects  for  months.  It  was,  therefore, 
most  desirable  to  substitute  for  such  a  general  action  a  merely 
topical  one,  if  such  an  one  subserved  the  purpose.  The  only 
case  in  which  he  had  ever  employed  a  local  anaesthetic  was  that 
of  an  infant  suffering  from  a  large  scroftdous  abscess  of  the 
neck.  To  this  he  applied  a  mixture  of  salt  and  snow  in  a  silk 
pocket  handkerchief,  and  then  made  a  free  incision,  and  evacua- 
ted about  a  tea-cupful  of  pus.  It  was  amusing  to  observe  the 
infant  laughing  at  the  very  moment  the  skin — ^which  was  in- 
flamed and  very  sensitive — ^was  being  handled  and  cut.  In  all 
similar  cases,  such,  for  example,  as  operating  in  paronychia,  it 
would  be  easy  to  employ  a  f^oiific  mixture,  and  it  would  avoid 
giving  intense^suffering.  The  employment  of  this  class  of 
remedies  for  minor  operations  has  been  ably  advocated  by  Dr. 
Amott  and  others ;  but  the  subject  took  a  wider  range  when  we 
attempted  to  apply  the  same  principle  to  the  treatment  of  those 
spasmodic  diseases  which  began  in  some  irritation  of  a  periphe- 
ral nerve  and  excited  general  convulsions.  This  was  the  case 
in  some  instances  of  epilepsy.  If  we  could  deaden  the  spot  at 
the  extremity  at  which  the  morbid  irritation  originated,  we 
might  sometimes  prevent  it  travelling  to  the  centre,  and  so  cut 
short  an  attack.  It  is  not  impossible  that  even  hydrophobia 
might  be  controlled  by  some  action  on  the  nerves  of  the  throat. 
In  short,  the  command  of  the  incito-motor  nerves  would  be  an 
immense  gain  of  therapeutic  power  in  many  convulsive  diseases, 
and  by  a  diligent  study  of  local  anaesthesia,  we  may  ultimately 
attain  it.  He  (Dr.  Eussell)  was  glad  to  find  the  subject  in  the 
hands  of  one  of  our  members,  and  he  hoped  at  some  future 
occasion  Dr.  Cronin  would  give  us  fuller  details  of  the  result 
of  his  experiments. 

Mr.  Cameron  remarked,  that  many  years  before  chloroform 
was  heard  of.  Dr.  Toogood  Downing  (who  gained  the  Jacksonian 
Prize  for  his  Essay  on  Neuralgia)  had  invented  an  instrument 
•which  he  named  the  "  Aneuralgicon "  by  means  of  which  he 
was  enabled  to  use  anaesthetics  of  various  kinds  locally,  and 
with  decided  success  in  many  cases.  He  employed  chiefly 
Belladonna^  Opium,  Coniimi,  Tobacco,  Hyoscyamus,  Hops,  and 
Lactaca  A  portion  of  one  or  more  of  these  agents  was  placed 
in -ft  imall  foinace,  which  fonned  the  body  of  the  infttrum^\i\,v!EA: 


342  OhservaHom  on  a  few  Local  AruesOieties. 

ignited.  A  stream  of  air  from  a  pair  of  small  bellows  was  then 
ilirtHtoil  upon  it  The  fames  escaped  into  a  hollow  cone  of 
lh»xiblo  mi>tal,  under  which  they  were  confined,  and  applied  to 
tlu»  i>iirt  affected.  The  pain  was  generally  speedily  relieved. 
Tho  almost  unavoidable  escape  of  these  powerful  fiimes>  and  ilieir 
inlialatii»u  by  the  patient  or  those  around  him  formed  a  serious 
objivtion,  according  to  Mr.  Cameron's  experience,  to  the  general 
use  of  this  otherwise  very  convenient  little  instrument.  K  this 
drawback  could  bo  overcome,  this  mode  of  employing  local 
auiiv^tlu'tios  ought  to  become  a  valuable  one,  and  seemed  de- 
siTving  of  more  attention  than  it  ever  received  from  the  pro- 
fession. 


%nmh  0f  i)^t  g0S|jital 


LECTUltE  III.— ON  ASTHMA. 
By  Db.  Eussell. 
TiiK  triuisition  from  epilepsy  to  asthma  is  natural  if  we  adopt 
a  pathological  arrangement,  and  even  in  the  purely  practical 
aspect  of  the  two  maladies  there  are  so  many  points  of  resem- 
blance, that  the  study  of  the  one  makes  the  comprehension 
of  tlio  other  an  easier  task.  True,  the  contrast  beween  epi- 
leptic and  asthmatic  persons  is  very  great.  Among  the  former 
the  majority  avo  greatly  l>elow  par  in  mental  power  and  activity, 
while  among  the  latter  the  reverse  is  the  rule,  and  asthma  has 
boon  described  as  jpar  excellence  the  complaint  of  the  intellectual 
class.  It  may  be,  that  the  rounded  shoulders  and  stooping 
gait  which  indicated  the  man  of  literature — ^before  literature 
took  to  the  rifle — was  mistaken  for  the  peculiar  formation  of 
the  chest  which  is  so  characteristic  of  the  asthmatic,  that  the 
accustomed  eye  can  at  once  recognise  the  sufferer  from  this 
complaint  the  moment  he  turns  his  back ;  or  it  may  be,  that 
the  peculiar  nervous  constitution  of  the  asthmatic  is  highly 
favourable  to  the  development  of  intellectual  vigour.     So  far 


Lecture  hy  Dr.  Russell.  343 

as  my  observations  have  gone,  they  quite  agree  with  the  popular 
belief.  The  asthmatics  I  have  known  have  been  persons  of 
unusual  mental  activity  and  energy. 

So  much  for  the  contrast  between  epilepsy  and  asthma.  The 
resemblance  between  these  two  diseases  consists  in  their  both 
being  affections  of  the  nervous  system,  of  a  profound  kind, 
connected  with  its  original  formation,  which  gives  to  it  a  ten- 
dency to  be  excited  into  a  peculiar  paroxysm  giving  rise  to 
certain  sensations  on  the  one  hand,  and  on  the  other,  to 
violent  spasms  of  certain  muscles.  In  asthma  as  in  epilepsy, 
what  may  be  called  the  head  quarters  of  the  disease  are  in  the 
upper  part  of  the  spinal  chord ;  about  the  origin  of  the  pneu- 
mogastric  nerves,  and  thence  it  extends  along  the  whole  of 
their  ramification  nerve,  giving  to  all  the  parts  supplied 
by  this  great  source  of  organic  sensibilty  a  preternatural 
sensitiveness  and  a  tendency  to  spasm.  The  morbid  centre 
of  epilepsy  is  probably  close  to  that  of  asthma^  but  the 
nerves  thence  proceeding,  by  producing  a  spasm  of  the  throat 
instead  of  the  lungs,  give  rise  to  the  phenomena  of  strangula- 
tion. So  contiguous,  however,  are  the  sources  of  the  two 
morbid  currents,  that  cases  are  on  record  of  the  usual  epileptic 
fit  being  supplanted  by  an  attack  of  asthma.  One  striking 
example  of  this  transmutation  is  thus  recorded  by  Dr.  Salter. 

"  The  case  was  that  of  a  man  of  about  fifty  years  of  age, 
subject  to  epilepsy.  His  fits  had  certain  weU-known  premo- 
nitory symptoms,  and  occurred  with  tolerable  regularity;  I 
think  about  once  a  fortnight.  On  one  occasion  his  medical 
attendant  was  sent  for  in  haste,  and  found  him  suffering  from 
violent  asthma ;  the  account  given  by  his  friends  was,  that  at 
the  usual  time  at  which  he  had  expected  the  fit,  he  had  ex- 
perienced the  accustomed  premonitoiy  symptoms,  but  instead 
of  their  being  followed,  as  usual,  by  the  convulsions,  this  violent 
dyspnoea  had  come  on.  Within  a  few  hours  the  dyspnoea  went 
oflF,  and  left  him  as  well  as  usual.  At  the  expiration  of  the 
accustomed  interval  after  this  attack,  the  ordinary  premonitory 


344  Lectur$  hy  Dr.  Russell. 

symptoms  and  the  usual  epileptic  fit  occurred.  On  several 
occasions  (I  do  not  know  how  many)  this  was  repeated,  the 
epileptic  seizure  being,  as  it  were,  supplanted  by  the  asthmatic." 
[Salter  on  Asthma,  p.  44.] 

Let  us  take  the  analogy  between  epilepsy  and  asthma  as 
our  chie,  and  see  whither  it  leads. 

To  begin  with ;  what  is  revealed  by  the  examination  of  the 
bodies  of  those  who  have  died  either  of  the  eflfects  of  these 
diseases,  or  who,  although  dying  of  other  maladies,  have  suffered 
from  either  of  them  ?  As  a  rule,  in  neither  has  there  yet  been 
found  any  constant  structural  change  which  can  be  held  as  an 
organic  cause  of  the  symptoms  ;  but  in  both  there  have  been 
occasionally  such  changes  observed,  and  in  both  the  morbid 
alterations  have  been  in  the  nervous  system. 

That  structural  change  is  rare,  we  state  on  the  high  autho- 
rity of  Laenec,  who  says  : — "  Even  at  the  period  at  which  we 
live,  when  the  eyes  of  medical  men  are  particularly  directed  to 
the  minute  investigation  of  the  anatomical  character  of  diseases, 
I  have  met  with  many  cases  in  which  it  was  impossible,  after 
the  most  minute  research,  to  find  any  organic  leison  whatever 
to  which  the  asthma  could  be  attributed."  So  much  for  the 
rule  ;  now  for  the  exceptions.  In  a  case  of  fatal  dyspnoea,  the 
body  of  the  patient  who  had  thus  died  was  carefully  examined 
by  the  accomplished  anatomist  Beclard,  who  foimd,  as  the  only 
possible  explanation  of  death,  a  tumour  on  one  of  the  phrenic 
nerves.  Parry  narrates  a  case  of  dyspnoea  occurring  in  fits  of 
aggravation,  without  any  symptoms  of  local  pulmonary  disease, 
and  on  dissection  he  found  morbid  alterations  in  the  upper 
cervical  vertebrae,  the  result  of  syphilitic  action  upon  the  bones 
of  the  neck.  Lastly,  Dr.  Gardener  relates  a  case  characterized 
during  the  life  of  the  patient  by  paroxysms  of  dyspnoea,  and 
the  post  mortem  examination  disclosed,  as  the  cause  of  the 
asthmatic  attacks  from  which  he  suffered,  a  neuromatous 
tumour  of  the  par  vagum.    [Ed.  Med.  Surg.  Joum.  1850.] 

Sir  John  Forbes  makes  upon  this  class  of  cases  the  following 


Lecture  h/  Dr.  RusBtlk  346 

practical  observations  : — "  The  influence  of  spinal  irritation  in 
producing  palpitation  and  other  irregular  action  of  the  heart  is 
well  known;  and  we  apprehend,  that  many  of  the  chronic 
dyspnoeas  and  irregular  asthmatic  affections  which  we  meet 
with  in  persons  who  are  deformed,  arise  as  frequently  from  dis- 
turbance of  the  spinal  marrow,  produced  by  the  distortion,  as 
from  disease  of  the  lungs  themselves."  (Cyclopaedia  of  Med. 
Asthma.) 

In  tracing  the  analogy  and  observing  the  contrast  between 
epilepsy  and  asthma,  there  is  one  point  of  diJBference  which 
arrests  the  attention.  It  is,  that  while  epilepsy  is  often  fatal, 
asthma  may  be  said  never  to  be  the  immediate  cause  of  death. 
There  are,  indeed,  one  or  two  instances  on  record,  which  perhaps 
ii^ay  by  some  be  considered  as  exceptions  to  this  rule.  Guersent 
relates  two  cases  of  infants  who  died  of  an  acute  remittent 
dyspnoea,  with  quick  pulse,  precordial  anxiety,  and  dry  cough, 
and  in  whose  bodies  no  organic  lesion  whatever  could  be  found. 
(Diet  de  Med.  Prat.,  t.  iii  p.  126.) 

Andral  relates  the  following  case  : — "  A  baker  of  good  con- 
stitution, twenty  years  of  age,  who  had  lived  in  Paris  for  only 
two  months,  and  who  had  been  affected  for  the  last  five  or  six 
weeks  with  a  slight  diarrhoea,  presented  on  the  10th  of  April 
all  the  precursory  symptoms  of  measles, — ^redness  of  the  eyes» 
coiyza,  hoarseness,  and  cough.  The  same  state  on  the  three 
following  days.  On  the  14th,  the  eruption  appeared;  the 
patient  kept  his  bed.  On  the  15th,  the  entire  body  was 
covered;  entered  La  Charity  on  the  evening  of  this  day.  The 
eruption  was  then  confluent,  and  quite  characteristic;  pulse 
hard  and  frequent ;  redness  of  tongue  and  lips ;  violent  cough ; 
no  other  bad  symptom.  Towards  the  middle  of  the  night  the 
patient  felt  some  oppression ;  this  increased  rapidly ;  and  on 
the  following  morning,  the  16  th,  we  found  the  patient  in  a 
state  of  semi-asphyxia ;  eyes  full  and  prominent ;  face  purple ; 
breathing  short  and  very  frequent,  performed  both  by  the  ribs 
and  diaphragm ;  cough  almost  constant,  some .  mucous  €;^\\lW\ 


346  Lecture  hy  Dr.  Russell. 

the  chest  when  percussed  sounded  well  in  every  part;  auscul- 
tation caused  some  mucous  rSle  to  be  heard  in  different  places. 
Of  the  eruption  there  remained  some  pale  spots  just  on  the 
point  of  disappearing.  The  pulse  preserved  its  frequency  and 
hardness,  and  the  tongue  its  redness.  This  group  of  symptoms 
seemed  to  indicate  the  existence  of  a  pneumonia ;  however, 
the  pathognomonic  signs  of  this  disease  were  completely 
wanting.  Could  a  simple  bronchitis  by  its  extreme  acuteness 
or  sudden  exasperation,  give  rise  to  so  intense  a  dyspnoea  ? 
Could  this  inflammation  in  combination  with  that  of  the 
primss  viae  explain  the  very  severe  state  into  which  the 
patient  had  so  suddenly  fallen  ?  Be  this  as  it  may,  the  indi- 
cations to  be  fulfilled  were  no  longer  doubtful  The  internal 
inflammation  must  be  diminished,  and  that  of  the  skin  recalled.'' 
Andral  attempted  to  effect  this  after  his  method,  and  the  result 
was,  that  under  intense  suffocation  the  patient  died  on  the  20th. 
The  post-mortem  examination  revealed  no  morbid  change  of  the 
parenchyma  of  the  lungs,  only  intense  redness,  and  some 
croupy  exudation  of  the  lining  membrane  of  the  bronchial 
tubes.  Andral,  while  on  the  whole  inclining  to  consider  the 
case  as  one  of  fatal  bronchitis,  seems  somewhat  staggered  as  to 
its  pathology,  for  he  observes :  "  Those  who  admit  the  existence 
of  nervous  dyspnoea  and  essential  asthmas,  might  cite  this  case 
in  support  of  their  opinion ;  they  would  say  that  they  had  often 
seen  the  bronchial  mucous  membrane  as  intensely  inflamed 
without  any  perceptible  dyspnoea  resulting  fix)m  it ;  from  this 
they  would  conclude  that  in  the  present  case,  the  dyspnoea 
was  an  essential  disease,  independent  of  the  inflammation  of 
the  bronchi"  I  have  quoted  this  case  in  full  because  of  its 
pathological  interest,  both  as  raising  the  question  as  to  whether 
this  baker  died  of  nervous  dyspnoea,  and  also  as  a  proof  of  the 
intimate  relation  between  cutaneous  and  some  pulmonary 
affections. 

As  the  cases  referred  to  and  the  one  quoted  are  almost  the 
ojAy  ones  recorded  of  presumed  death  by  asthma,  we  may  as- 


Lecture  ly  Dr.  Russell.  847 

some  that  in  tlfls  Instance  the  exceptions  prove  the  rule,  and 
that  asthma  is  never  fatal  Why  not  ?  If  asthma  be  what  it 
is  generally  represented  as  being,  a  spasm  of  the  muscular 
structure  which  surrounds  the  extreme  ramifications  of  the 
bronchial  tubes  just  as  they  loose  themselves  in  the  air  cells, 
— ^if  this  be  the  true  pathology  of  asthma,  then  the  conse- 
quences would  manifestly  be,  that  the  lung  cells  would  be 
deprived  of  the  supply  of  air  requisite  to  the  maintenance  of 
life,  and  we  should  have  the  symptoms  of  death  by  strangu- 
lation. For  where  is  the  difference  to  the  individual,  whether 
he  be  choked  by  a  ligature  round  his  windpipe— or  what  is  the 
same  thing,  by  spasmodic  closure  of  the  glottis,  so  that  no  air 
is  permitted  to  enter  the  tubes  and  be  conveyed  along  them 
through  their  subdivisions  to  the  lungs,  or  whether  the  air  so 
entering  be  arrested  at  the  extremities  of  these  tubes,  and  the 
craving  of  the  parched  air  cells  be  left  unsatisfied  ?  In  the 
former  case  the  patient  is  suffocated  by  a  wholesale  process,  and 
in  the  latter,  he  is  suffocated  in  detail ;  but  in  both  cases  he  is 
equally  suffocated,  if  by  suffocation  we  understand  depriving 
the  lungs  of  the  supply  of  air  necessary  for  life.  And  what  do 
we  mean  by  suffocation  ?  We  mean  that  the  blood  passes 
through  the  lungs  without  being .  there  renovated  as  it  should 
be, — ^r^enerated,  we  might  even  say, — and  that  instead  of  living 
arterial  blood,  dead  venous  blood  is  poured  into  the  left  auricle, 
thence  into  the  left  ventricle,  which  in  its  turn  discharges  it 
upon  the  brain,  and  produces  there  the  effects  which  Sir  A. 
Cooper  describes  as  having  been  exhibited  by  the  rabbits,  whose 
carotid  and  cervical  arteries  he  had  tied,  viz.,  coma,  convul- 
sions, and  all  the  after  phenomena  of  epilepsy.  But  in  asthma 
we  have  as  nearly  as  possible  the  converse  of  all  this.  So  far 
fix>m  there  being  coma  or  unconsciousness,  there  is  quickened 
perception;  instead  of  convulsions,  we  have  absolute  stillness 
of  every  limb  and  muscle,  with  one  grand  exception,  the 
mnades  of  respiration.  All  these,  and  none  else,  are  in  a 
'Siite  of  violently  exalted  action.     So  that  we  may,  without  aja.^ 


348  Leettt/re  hy  Dr.  Russdl. 

conceit  of  language,  call  asthma  epilepsy  of  the  tespixatory 
apparatus. 

The  respiratory  apparatus  consists  of  a  certain  arrangement 
of  muscles  and  of  nerves,  by  which  the  chest  is  expanded  and 
the  lungs  inflated.  Clearly  to  understand  the  phenomena  of 
asthma,  we  must  fully  comprehend  these  two  sets  of  apparatus. 
The  muscles  of  the  trunk  which  are  brought  in  aid  of  the 
common  respiratory  muscles  are  thus  described  by  Sir  C.  Bell : — 
*'  If  we  look  upon  the  frame  of  the  body  for  the  purpose  of 
determining  what  are  the  muscles  best  calculated  to  assist  in 
the  motions  of  the  chest  when  there  is  an  increased  or  excited 
action,  we  shall  have  little  difficulty  in  distinguishing  them; 
and  we  shall  have  as  little  hesitation  in  assigning  a  use  to  the 
nerves  which  supply  those  muscles  exclusively.  These  muscles, 
in  effect  we  see  powerfully  influenced  by  deep  inspiration,  how- 
ever excited.  They  are  the  mastoid  muscle,  the  trapezius,  the 
serratus  magnus,  and  the  diaphragm.  They  operate  in  a  circle, 
and  all  would  be  useless  in  the  act  of  respiration  were  one  to  be 
wanting.  The  servatus  magnus  expands  the  ribs ;  but  this  it  does 
only  when  the  scapula,  to  which  it  is  attached,  is  fixed ;  and  unless 
the  scapula  be  fixed,  this  muscle  has  no  operation  in  breathing. 
The  trapezius  fixes  the  scapula  by  drawing  it  backwards  and 
upwards.  These  two  muscles  must  always  correspond  in  action 
in  order  to  expand  the  chest.  Now  let  us  see  how  the  tra- 
pezius influences  the  operation  of  the  stemo-cleido-mastoideus. 
The  mastoid  muscle  elevates  the  sternum ;  but  only  when  the 
head  is  fixed,  which  is  done  by  the  action  of  the  trapezius  on 
the  back  of  the  head  and  neck.  To  this  train  of  coimections 
we  may  join  the  diaphragm  itself,  since,  without  the  action  of 
the  serratus,  the  margins  of  the  thorax  would  sink  in  by  the 
action  of  the  diaphragm,  and  the  force  of  that  muscle  would  be 
consequently  lost." 

This  description  by  the  masterly  pen  of  Sir  C.  Bell,  exhibits 
at  once  the  peculiar  form  of  the  upper  part  of  the  back,  and 
habitual  attitude  of  the  asthmatic     His  shoulder-bladei  haT« 


Lecture  hy  Dr,  Russell,  349 

been  so  often  raised  and  fixed,  to  give  purchase  to  his  serrati 
muscles,  that  his  shoulders  have  become  permanently  round 

So  much  for  the  external  muscles  of  respiration.  Let  us 
now  glance  at  the  sketch  by  the  same  hand  of  the  nerves 
devoted  to  associate  these  muscles  in  combined  action.  *'  The 
nerves  on  which  the  associated  actions  of  voluntary  BJid  excited 
respiration  depend,  arise  very  nearly  together.  Their  origins 
are  not  in  a  bimdle  or  fasciculus,  but  in  a  line  or  series,  and 
form  a  distinct  column  of  the  spinal  marrow.  Behind  the 
corpus  olivare  there  is  a  portion  of  the  medulla  which  belongs 
neither  to  the  motor  nor  to  the  sensitive  tracts,  and  which  on 
dissection  wiU  be  found  to  have  more  direct  connection  with 
the  corpus  restiforme.  This  fasciculus,  or  virga,  may  be  traced 
down  the  spinal  marrow  between  the  sulci,  which  gives  rise  to 
the  anterior  and  posterior  roots  of  the  spinal  nerves." 

"  From  this  tract  of  the  medullary  matter  on  the  side  of  the 
medulla  oblongata  arise  in  succession  from  above  downwards, 
the  portio  dura  of  the  seventh  nerve,  the  glosso-pharangeus  ;  the 
nerve  of  the  par  vagum,  the  nervus  ad  par  vagum  accessorius, 
and,  as  I  imagine,  the  phrenic  and  external  respiratory  nerves." 

Thus  the  principal  seat  of  the  power  which  controls  respira- 
tion is  within  a  very  narrow  compass.  Now  as  epilepsy  is 
held  by  Schroder  van  der  Koch  to  arise  from  a  morbid  con- 
dition of  a  small  portion  of  the  medulla  oblongata,  so  pro- 
bably does  asthma,  or  at  least  the  disposition  to  asthma,  de- 
pend upon  a  chronic-inflammation  (shaU  we  say?)  of  a 
contiguous  part  of  this  vital  structure ;  and  as  the  only  con- 
ceivable means  of  a  radical  cure  of  epilepsy,  is  by  remedies 
which  act  upon  the  origin  of  the  disease,  so  I  believe  that  we 
shall  find  that  to  cure  asthma  we  must  look  not  so  much  at 
the  outward  manifestation  of  the  malady,  as  at  its  inward 
source.  Suppose  we  are  right  in  this  interpretation  of  the 
pathology  of  asthma,  and  that  the  disease  depends  upon  a 
morbid  condition  of  what  for  want  of  a  better  name,  we  may 
denominate,  after  Bell,  the  respiratory  tract ;  what  should  we 


3  50  Lecture  hy  Dr,  Russell 

expect  to  result  from  such  a  condition  of  the  origin  of  the 
nerves?  Let  us  see  what  takes  place  in  epilepsy.  Here 
we  have,  in  consequence  of  a  similar  state  of  the  roots  of  the 
nerves  of  common  sensation  and  motion,  the  following  pheno- 
mena. 

Ist.  A  peculiar  morbid  sensation — a  modification  of  the 
ordinary  sense  of  feeling,  known  by  the  term,  av/ra  epilqptica- 

2nd.  After  this  peculiar  sensation  has  been  borne  inward  to 
the  centre,  we  have  by  the  law  of  reflex  action,  certain  twitches 
in  the  muscles  of  the  face  and  eye,  because  the  roots  of  the 
nerves  which  supply  these  muscles,  have  been  excited  by  the 
in-borne  impulse  known  as  a  sensation. 

What  have  we  in  asthma  ? 

Suppose  the  nervtcs  vagtcs  to  be  morbid  at  its  root,  what 
should  we  expect  to  be  the  phenomena  ?  Why,  that  as  one  of 
its  offices  is  to  endow  the  lungs,  not  with  common  sensibility, 
but  with  the  peculiar  sensibility  which  enables  them  to  per- 
ceive the  presence  of  unoxynated  blood,  and  to  transmit  an 
order,  so  to  speak,  for  a  fresh  supply  of  air,  that  they  may  be 
permeated  by  the  vital  fluid ;  so,  when  there  is  a  morbid  con- 
dition of  the  pulmonary  branch  of  this  nerve,  there  is,  as  a 
necessary  consequence,  a  preternatural  sensitiveness  to  the 
natural  stimulus,  and  hence  there  is  a  cruel  craving  for  fresh 
air,  giving  rise  to  a  sense  of  suffocation."  This  sense  of 
suffocation,  when  it  arrives  at  the  centre  of  consciousness  and 
the  origin  of  motion,  immediately  calls  into  the  greatest  ac- 
tivity the  whole  muscular  apparatus  at  its  disposal,  to  relieve 
the  anguish  produced  by  this  intolerable  sensation — ^this  true 
mimic  death — long  drawn  out — which  the  asthmatic  endures ; 
a  sense  of  suffocation — but  not  suffocation — ^is  the  essence  of 
asthma,  for  there  is  no  lack  of  air  in  the  lungs.  Instead  of 
there  being  too  little  air  in  them,  they  are  distended  almost  to 
bursting;  but  the  air  does  not  satisfy  the  craving.  The 
patient  sits  with  his  mouth  open,  gasping  like  a  fish  out  of 
water.     From  the  mouth  and  nostrils  to  the  innermost  cells  of 


Lecture  by  Dr.  Rvssell.  351 

the  lungs,  there  Is  no  Impediment  to  the  entrance  of  the  vital 
breath ;  but  it  does,  so  far  as  his  sensatisns  go,  no  good.  How 
does  this  affect  the  circulation  ?  The  over-distended  air-cells 
do  not  permit  a  free  entrance  of  blood  through  their  capillary 
vessels:  the  consequence  is,  that  along  with  an  inordinate 
appetite  for,  not  air,  but  vivication  of  the  blood — this  being 
what  we  mean  when  we  speak  of  want  of  breath — ^there  is  a 
deficiency  in  the  process  by  which  the  venous  blood  is  reno- 
vated. Too  small  a  quantity  passes  through ;  what  does  pass 
however,  undergoes  the  necessary  changes ;  it  reaches  the  left 
auricle  in  a  sparing  stream,  but  what  gets  there  is  arterial 
living  blood,  not  dead  venous  blood.  This  limited  supply  of 
stimulating  blood,  excites  the  heart,  which  propels  it  rapidly 
but  feebly  through  the  system  at  large,  and  up  to  the  brain. 
The  pulse  is  rapid  and  small  in  consequence ;  the  skin  shrivelled 
and  cold ;  the  brain  clear— often  wonderfcdly  cleai' — ^but  not 
fit  for  any  effort 

If  the  air  instead  of  entering,  as  I  believe  it  does,  the 
tissue  of  the  lungs,  were  shut  off,  as  our  authorities  tell  us  it 
is,  what  would  be  the  condition  of  the  blood  ?  Why,  manifestly 
it  would  be  yenous,  and  we  should  have  venous  blood  entering 
the  left  side  of  the  heart,  and  thence  transmitted  through  the 
brain.  Now  if  for  hours  this  was  to  go  on,  how  is  it  possible 
that  the  person  could  avoid  manifesting  the  unequivocal  sjnoap- 
toms  of  venous  congestion  of  the  brain  ?  We  know  what  these 
are, — ^we  know  exactly  how  long  it  takes  to  induce  coma  and 
convulsions,  and  yet  there  is  no  instance  on  record  of  either 
coma  or  convulsions  being  induced  by  attacks  of  asthma,  even 
although  of  the  severest  and  most  enduring  kind. 

Among  the  arguments  usually  advanced  in  support  of  what 
I  look  upon  as  the  erroneous  though  prevailing  doctrine  of 
asthma  being  a  spasm  of  the  entrance  of  the  air-cells,  one 
much  dwelt  on  is  the  instant  relief  which  is  given  by  what 
are  considered  sedatives.  I  believe  there  is  here  a  double 
fidlacy;  first,  that  what  is  relieved  is  not  a  preventing  spaam.^ 


352  Lecture  by  Dr.  Russell, 

but  an  uneasy  sensation — anxiety — and  that  the  so-called 
sedatives  relieve  this  either  in  virtue  of  their  specific  action  on 
the  nerves,  by  curing  the  morbid  condition  of  which  this  is  a 
symptom, — as  happens  when  Ipecacuhana  and  Lobelia  do  it,  or, 
when  Chloroform  and  Opium  are  the  means  successfully  em- 
ployed, it  is  in  virtue  of  their  primary  or  stimulating,  and  not 
their  sedative  action,  that  they  effect  the  change.  Nothing 
exemplifies  this  better  than  the  relief  given  by  burning  nitre- 
paper,  one  of  the  palliatives  most  frequently  efficacious.  So 
far  from  the  fumes  of  the  nitric-oxide,  which  is  liberated  by 
the  combustion  of  the  nitre  being  of  a  sedative  or  soothing 
nature,  they  are  intensely  irritating  to  the  air  passages,  so  that 
a  person  who  has  riot  asthma,  if  he  attempt  to  breathe  this 
vapour,  is  certain  to  be  attacked  with  a  sense  of  suffocation  and 
a  fit  of  coughing. 

While  we  regard  the  essence  of  asthma  to  be  an  exaltation 
of  the  peculiar  or  specific  sensibility  of  the  pulmonary  branch 
of  the  par  vagum,  from  some  morbid  condition  of  that  portion 
of  the  spinal  chord  whence  this  nerve  springs,  as  well  as  a 
morbid  state  of  the  other  nerves  of  inspiration  depending  upon 
something  vicious  at  their  roots,  so  that  they  convey  an  un- 
natural stimulus  to  the  muscles  they  supply,  which  induces 
them  to  take  on  a  spasmodic  action — just  as  those  of  the 
limbs  do  in  epilepsy,  we  must  at  the  same  time  remember 
that  the  functions  of  the  nervus  vagus  is  very  complex,  and  that 
it  is  not  merely  a  nerve  endowing  the  lungs  with  their  peculiar 
sensitiveness  to  the  presence  of  venous  blood  in  their  capillaries  ; 
but  also  the  source  of  nervous  influence  to  the  mucous  and 
muscular  tissues,  which  enter  into  the  composition  of  the  rami- 
fications of  the  bronchial  tube  and  air-cells. 

Now  let  us  inquire  into  the  effect  of  the  enfeeblement  of  this 
supply  of  nervous  force  to  the  mucous  membrane,  and  the 
muscles  of  the  bronchial  tubes — so  beautifully  delineated  by 
Eeisseisen.  We  know  by  abundant  physiological  experiments, 
as  well  as  by  pathological  conditions,  that  when  any  mneous 


On^Asthmn.  353 

membrane  is  depiiyed  of  its  natural  amount  of  nervous  in* 
fluenoe  the  consequence  is,  that  the  capillaries  of  tiie  part  so 
maltreated  enlarge,  and,  if  the  process  be  of  long  duration,  that 
instead  of  secreting  their  natural  mucus,  they  first  become  dry 
imd  then  secrete  an  altered  or  puriform  discharge.  This  is 
well  illustrated  in  the  eye.  Such  a  change  takes  place  in  the 
mucous